title: Causes of death in 2877 patients with myelodysplastic syndromes.
abstract: Patients with myelodysplastic syndromes face a poor prognosis. The exact causes of death have not been described properly in the past. We performed a retrospective analysis of causes of death using data of 3792 patients in the Düsseldorf registry who have been followed up for a median time of 21 months. Medical files as well as death certificates were screened and primary care physicians were contacted. Death after AML evolution, infection, and bleeding was considered to be clearly disease-related. Further categories of causes of death were heart failure, other possibly disease-related reasons, such as hemochromatosis, disease-independent reasons as well as cases with unclear causes of death. Median age at the time of diagnosis was 71 years. At the time of analysis, 2877 patients (75.9 %) had deceased. In 1212 cases (42.1 %), the exact cause of death could not be ascertained. From 1665 patients with a clearly documented cause of death, 1388 patients (83.4 %) succumbed directly disease-related (AML (46.6 %), infection (27.0 %), bleeding (9.8 %)), whereas 277 patients (16.6 %) died for reasons not directly related with myelodysplastic syndromes (MDS), including 132 patients with cardiac failure, 77 non-disease-related reasons, 23 patients with solid tumors, and 45 patients with possibly disease-related causes like hemochromatosis. Correlation with IPSS, IPSS-R, and WPSS categories showed a proportional increase of disease-related causes of death with increasing IPSS/IPSS-R/WPSS risk category. Likewise, therapy-related MDS were associated with a higher percentage of disease-related causes of death than primary MDS. This reflects the increasing influence of the underlying disease on the cause of death with increasing aggressiveness of the disease.
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany. kathrin.nachtkamp@med.uni-duesseldorf.de.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Nachtkamp
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
authors.forename: Romina
authors.initials: R
authors.lastname: Stark
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Strupp
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Kündgen
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, St. Johannes Hospital, Duisburg, Germany.
authors.forename: Aristoteles
authors.initials: A
authors.lastname: Giagounidis
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, St. Johannes Hospital, Duisburg, Germany.
authors.forename: Carlo
authors.initials: C
authors.lastname: Aul
authors.affiliation: Department of Human Genetics, Heinrich-Heine-University, Düsseldorf, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hildebrandt
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Haas
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Gattermann
authors.affiliation: Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Germing
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000401:mortality*; D012189:Retrospective Studies
keywords: Causes of death; Myelodysplastic syndromes; Prognosis