Publication Only: Myelodysplastic syndromes - Clinical
Myelodysplastic syndromes refer to a heterogeneous group of clonal diseases affecting the hematopoietic stem cell resulting in qualitative and quantitative abnormalities of the three myeloid lineages. The overall incidence is 03-05/105 hbts/year without ethnic difference; it increases with age (03-15/105 hbts/year between 50-70 years and 15-50/105 hbts/year> 70 years).
we analyzed the characteristics of our patients and we investigated the impact of prognostic factors and parculier comorbidities on their future
a single-center descriptive retrospective study, including all MDS diagnosed in the hematology department of military hospital over a 21-year period (1994-2014) from patient records. The diagnosis is retained on blood and bone marrow cytology and Perls staining (the karyotype was carried out in a few cases) after exclusion of a vitamin deficiency (ferritin, folate, vitamin B12: dosage or therapeutic test), or associated pathology (thyroid, lever, inflammatory or haemolytic). We have classified our patients according to the WHO classification (2016).
n = 85 evaluable pts: the clinical, biological and cytological characteristics of patients are summarized in the following table I, the observed comorbidities: cardiovascular d (40%), diabetes (30%), and respiratory insufficiency (29%): more frequent (HR = 1.65, 95% CI = 0.65- 3, 66) in men/women and more severe (≥3 points: 12 patients): HR: 4.5: 95% CI: 1, 88-5) P = 0.012. Patients 65 years and older have a high prevalence of comorbidities (vs young): HCT-CI score: HR = 0, 19 (95% CI: 0, 023-0, 89): p = 0.01, with a very negative impact on survival (p = 0.001).
the presentation of MDS in our series is similar to that of national and international series with a particularly poor prognosis since this pathology preferentially affects the elderly, with in most cases associated defects making the management very difficult. Immunomodulatory agents could improve the evolution of these patients.