title: [A preliminary study of prognostic value of thrombocytopenia in patients with primary myelodysplastic syndromes].
abstract: OBJECTIVE
  To investigate the prognostic value of thrombocytopenia in patients with primary myelodysplastic syndromes (MDS).
  
  
  METHODS
  Four hundred and nineteen primary MDS patients were retrospectively analyzed. Kaplan-Meier method, Log-rank test and COX regression model were used to evaluate factors that influence the prognosis.
  
  
  RESULTS
  Two hundred and fifty-six cases (61.1%) had thrombocytopenia (PLT < 100×10(9)/L), one hundred and three cases (24.6%) had severe thrombocytopenia (PLT < 30×10(9)/L). Overall survival (OS) tended to shorten along with the decreasing of platelet count. Univariate analysis indicated that PL < 30×10(9)/L, MCV ≤ 95 fl, LDH ≥ 300 U/L, lymphocyte-like micromegakaryocyte, nucleated RBC PAS positive, IPSS cytogenetic intermediate- and poor-risk were all related with poor prognosis. Moreover, the prognosis of patients with RCMD, RAEB-Ior RAEB-IIwas poorer than that of the other subgroups. Among these parameters, PLT < 30×10(9)/L, MCV ≤ 95 fl, IPSS cytogenetic intermediate- and poor-risk group and RCMD, RAEB-I and RAEB-II had independent prognostic significance in multivariate analysis. Modified WPSS prognostic model was proposed by adopting PLT, MCV, chromosomal karyotype and WHO classification. The OS of patients with low risk, intermediate-1 risk, intermediate-2 risk and high risk were 59, 28, 14 and 4 months, respectively, and there was a statistically significant difference between the groups (P < 0.05).
  
  
  CONCLUSIONS
  Severe thrombocytopenia indicated unfavorable prognosis, in combination with MCV, chromosomal karyotype and WHO classification, a modified WPSS prognostic model was proposed and worked well for prognostic indication in patients with MDS.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, State Key Laboratory of Experimental Hematology, Tianjin 300020, China.
authors.forename: Yue-dan
authors.initials: YD
authors.lastname: Chen
authors.forename: Ze-feng
authors.initials: ZF
authors.lastname: Xu
authors.forename: Rui
authors.initials: R
authors.lastname: Cui
authors.forename: Jie-yu
authors.initials: JY
authors.lastname: Wang
authors.forename: Tian-jiao
authors.initials: TJ
authors.lastname: Zhang
authors.forename: Li-wei
authors.initials: LW
authors.lastname: Fang
authors.forename: Hong-li
authors.initials: HL
authors.lastname: Zhang
authors.forename: Tie-jun
authors.initials: TJ
authors.lastname: Qin
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhi-jian
authors.initials: ZJ
authors.lastname: Xiao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult