title: Epidemiologic study of myelodysplastic syndromes in a multiethnic, inner city cohort.
abstract: Little is known about the epidemiology of MDS in minority populations. The IPSS and newly released IPSS-R are important clinical tools in prognostication of patients with MDS. Therefore, we conducted a retrospective epidemiological analysis of MDS in an ethnically diverse cohort of patients. Demographics, disease characteristics, and survival were determined in 161 patients seen at Montefiore Medical Center from 1997 to 2011. We observed that Hispanics presented at a younger age than blacks and whites (68 vs. 73.7 vs. 75.6 years); this difference was significant (p = 0.01). A trend towards greater prevalence of thrombocytopenia in Hispanics was observed, but this was not significant (p = 0.08). No other differences between the groups were observed. Overall median survival after diagnosis was the highest among Hispanics (8.6 years) followed by blacks (6.2 years) and Caucasians (3.7). Adjusted hazard ratios however did not show significant differences in risk of death between the groups. The IPSS-R showed slightly better discrimination when compared to the IPSS in this cohort (Somers Dxy 0.39 vs. 0.35, respectively) but observed survival more was more closely approximated by IPSS than by IPSS-R. Our study highlights the possibility of ethnic differences in the presentation of MDS and raises questions regarding which prognostic system is more predictive in this population.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Sridharan
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Rishi
authors.initials: R
authors.lastname: Jain
authors.affiliation: Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA ; Robert Wood Johnson Foundation Clinical Scholars Program, Univeristy of Pennsylvania, Philadelphia, PA, USA ; Leonard Davis Insititute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Bachhuber
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 302B Chanin, 1300 Morris Park Ave, Bronx, NY 10461, USA.
authors.forename: Yiting
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Kh
authors.initials: Kh
authors.lastname: Ramesh
authors.affiliation: Department of Hematology, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Krishna
authors.initials: K
authors.lastname: Gundabolu
authors.affiliation: Department of Hematology, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Friedman
authors.affiliation: Division of Oncology, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Amit K
authors.initials: AK
authors.lastname: Verma
keywords: Ethnicity; IPSS; IPSS-R; Myelodysplastic syndrome; Prognosis