title: Myelodysplastic syndromes in South America: a multinational study of 1080 patients.
abstract: There are previously reported data describing differences between Asian and European patients with Myelodysplastic Syndromes (MDS), few direct comparisons based on cancer registration characteristics or using cohorts to validate scoring systems. This is the first study from South-America, which attempts to describe demographic, clinical features, and outcome of MDS patients. We retrospectively analyzed 1,080 patients with de novo MDS from Argentina (635), Brazil (345), and Chile (100). Chilean patients were younger (P = 0.001) with female preponderance (P = 0.071). Brazilian series showed a higher predominance of RARS subtype regarding FAB and WHO classifications (P < 0.001). Hemoglobin levels were significantly lower in Brazilian and Chilean series (P < 0.001), and Chilean series also showed a lower platelet count (P = 0.028), with no differences concerning the neutrophil count, % BM blast, and the distribution of cytogenetic risk groups (P > 0.05). Chilean series depicted a lower overall survival (OS; 35 months vs. 56 months-Argentine; 55 months-Brazil, P = 0.030), which was consistent with a higher predominance of the high-risk group according both to the IPSS and IPSS-R (P = 0.046 and P < 0.001). The IPSS-R system and its variables showed a good reproducibility to predict clinical outcome for the whole South-American population. Epidemiological and clinical characteristics, distribution among prognostic subgroups, the OS, and the access to disease modifying therapies were more similar between Argentinean and Brazilian compared with Chilean MDS series. This will need further analysis in a larger group of patients. Descriptive and comparative studies are necessary to establish epidemiological features useful for public health attitudes to generate suitable therapeutic schemes.
authors.affiliation: Instituto de Medicina Experimental (IMEX-CONICET)/Academia Nacional de Medicina, Laboratorio de Genética Hematológica, Buenos Aires, Argentina.|On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología, Buenos Aires, Argentina.
authors.forename: Carolina B
authors.initials: CB
authors.lastname: Belli
authors.affiliation: Federal University of Ceara, Departamento de Medicina Clínica, Ceara, Brazil.
authors.forename: Ronald Feitosa
authors.initials: RF
authors.lastname: Pinheiro
authors.affiliation: Instituto de Medicina Experimental (IMEX-CONICET)/Academia Nacional de Medicina, Laboratorio de Genética Hematológica, Buenos Aires, Argentina.
authors.forename: Yesica
authors.initials: Y
authors.lastname: Bestach
authors.affiliation: Instituto de Medicina Experimental (IMEX-CONICET)/Academia Nacional de Medicina, Laboratorio de Genética Hematológica, Buenos Aires, Argentina.
authors.forename: Irene B
authors.initials: IB
authors.lastname: Larripa
authors.affiliation: Hematology and Transfusion Medicine, Hospital Das Clinicas, University of Sao Paulo, Brazil.
authors.forename: Roberta Sandra
authors.initials: RS
authors.lastname: da Silva Tanizawa
authors.affiliation: Servicio de Hematología, Hospital General de Agudos "A. J. Posadas", El Palomar, Argentina.|On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología, Buenos Aires, Argentina.
authors.forename: Graciela
authors.initials: G
authors.lastname: Alfonso
authors.affiliation: Servicio de Hematología, Hospital General de Agudos "C Durand,", Buenos Aires, Argentina.|On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología, Buenos Aires, Argentina.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Gonzalez
authors.affiliation: Servicio de Hematología, Hospital General de Agudos "Tornú,", Buenos Aires, Argentina.|On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología, Buenos Aires, Argentina.
authors.forename: Mariana
authors.initials: M
authors.lastname: Rosenhain
authors.affiliation: Servicio de Hematología, Hospital General de Agudos "Ramos Mejía,", Buenos Aires, Argentina.
authors.forename: Nora
authors.initials: N
authors.lastname: Watman
authors.affiliation: Hematology and Transfusion Medicine, Hospital Das Clinicas, University of Sao Paulo, Brazil.
authors.forename: Marcela
authors.initials: M
authors.lastname: Cavalcante de Andrade Silva
authors.affiliation: Instituto Privado de Hematología y Hemoterapia, Paraná, Argentina.
authors.forename: Pedro
authors.initials: P
authors.lastname: Negri Aranguren
authors.affiliation: Servicio de Patología, Hospital Italiano de, Buenos Aires, Argentina.|On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología, Buenos Aires, Argentina.
authors.forename: Hernán
authors.initials: H
authors.lastname: García Rivello
authors.affiliation: Federal University of Ceara, Departamento de Medicina Clínica, Ceara, Brazil.
authors.forename: Silvia M M
authors.initials: SM
authors.lastname: Magalhaes
authors.affiliation: Hematolologia Clínica, Hospital Del Salvador, Santiago, Chile.
authors.forename: Ximena
authors.initials: X
authors.lastname: Valladares
authors.affiliation: Hematolologia Clínica, Hospital Del Salvador, Santiago, Chile.
authors.forename: María S
authors.initials: MS
authors.lastname: Undurraga
authors.affiliation: Hematology and Transfusion Medicine, Hospital Das Clinicas, University of Sao Paulo, Brazil.
authors.forename: Elvira R P
authors.initials: ER
authors.lastname: Velloso
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D013020:South America / Q000453:epidemiology