E Balleari1, C Salvetti2, L Del Corso2, R Filiberti3, A Bacigalupo2, A Bellodi2, G Beltrami2, M Bergamaschi2, G Berisso4, T Calzamiglia5, A M Carella2, M Cavalleri6, A Da Col2, S Favorini2, G L Forni7, R Goretti8, M Miglino2, L Mitscheuning2, E Molinari2, O Racchi9, M Scudeletti6, R Tassara10, M Gobbi2, R Lemoli2, M Clavio2. 1. Department of Hematology and Oncology, IRCCS AOU San Martino - IST, Largo R. Benzi, 10, 16132 Genova, Italy. Electronic address: balleari@unige.it. 2. Department of Hematology and Oncology, IRCCS AOU San Martino - IST, Largo R. Benzi, 10, 16132 Genova, Italy. 3. Clinical Epidemiology, IRCCS AOU San Martino - IST, Largo R. Benzi, 10, 16132 Genova, Italy. 4. UO Internal Medicine - ASL 5, Via Cisa 4, 119038 Sarzana, SP, Italy. 5. UO Internal Medicine - ASL 1, Via Giovanni Borea 56, 18038 Sanremo, IM, Italy. 6. UO Internal Medicine - ASL 4, Via Arnaldo Terzi 43, 16039 Sestri Levante, GE, Italy. 7. UO Hematology - EO Galliera, Mura Delle Cappuccine 14, 16128 Genova, Italy. 8. UO Internal Medicine - ASL 2, Via XXV Aprile 38, 17027 Pietra Ligure, SV, Italy. 9. UO Hemato-Oncology - ASL 3, Via Antonio Cantore 3, 16149 Genova, Italy. 10. UO Internal Medicine - ASL 2, Via Genova, 3, 17100 Savona, Italy.
Abstract
BACKGROUND: Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorders, with very different prognosis in given individuals; age and comorbidities are emerging as relevant patient-related factors influencing clinical outcome in MDS. Our aim was to evaluate the impact of age, comorbidities and disease severity (IPSS and IPSS-R prognostic scores) in a "real-life" series of MDS patients. METHODS: 318 patients with available assessment of comorbidities at diagnosis and consecutively registered into the Registro Ligure delle Mielodisplasie were analyzed. Comorbidities were evaluated according to HCT-CI and MDS-CI comorbidity indexes. Overall survival (OS) and the probability of death among patients who did not develop acute myeloid leukemia (NLD cumulative incidence) were analyzed. RESULTS: Comorbidities were seen in 177 (55.7%) patients. An older age (>75 y) had a significant negative impact on OS (p=0.008). HCT-CI was not associated with OS. MDS-CI was of prognostic significance (p=0.001), but the association was limited to pts with IPSS or IPSS-R "lower-risk". In multivariate analysis, MDS-CI remained an independent factor associated with OS and with an increased risk of NLD both when controlling for IPSS (p=0.019 and p=0.001, respectively) and for IPSS-R (p=0.048 and p=0.002, respectively). CONCLUSIONS: Evaluation of age and comorbidities according to a tailored tool such is MDS-CI helps to predict survival in patients with MDS and should be incorporated to current prognostic scores.
BACKGROUND:Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorders, with very different prognosis in given individuals; age and comorbidities are emerging as relevant patient-related factors influencing clinical outcome in MDS. Our aim was to evaluate the impact of age, comorbidities and disease severity (IPSS and IPSS-R prognostic scores) in a "real-life" series of MDSpatients. METHODS: 318 patients with available assessment of comorbidities at diagnosis and consecutively registered into the Registro Ligure delle Mielodisplasie were analyzed. Comorbidities were evaluated according to HCT-CI and MDS-CI comorbidity indexes. Overall survival (OS) and the probability of death among patients who did not develop acute myeloid leukemia (NLD cumulative incidence) were analyzed. RESULTS: Comorbidities were seen in 177 (55.7%) patients. An older age (>75 y) had a significant negative impact on OS (p=0.008). HCT-CI was not associated with OS. MDS-CI was of prognostic significance (p=0.001), but the association was limited to pts with IPSS or IPSS-R "lower-risk". In multivariate analysis, MDS-CI remained an independent factor associated with OS and with an increased risk of NLD both when controlling for IPSS (p=0.019 and p=0.001, respectively) and for IPSS-R (p=0.048 and p=0.002, respectively). CONCLUSIONS: Evaluation of age and comorbidities according to a tailored tool such is MDS-CI helps to predict survival in patients with MDS and should be incorporated to current prognostic scores.
Authors: Amy M Linabery; Michelle A Roesler; Michaela Richardson; Erica D Warlick; Phuong L Nguyen; Adina M Cioc; Jenny N Poynter Journal: Cancer Epidemiol Date: 2022-01-05 Impact factor: 2.984