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Multicenter Study
. 2010 Jan;21(1):114-9.
doi: 10.1093/annonc/mdp258. Epub 2009 Jul 15.

Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study Group

W R Sperr  1 , F Wimazal, M Kundi, C Baumgartner, T Nösslinger, A Makrai, R Stauder, O Krieger, M Pfeilstöcker, P Valent
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Free article
Multicenter Study

Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study Group

W R Sperr et al. Ann Oncol. 2010 Jan.
Free article

Abstract

Background: The evaluation of comorbidity is of increasing importance in patients with hematologic disorders.

Patients and methods: In the present study, the influence of comorbidity on survival and acute myeloid leukemia (AML) evolution was analyzed retrospectively in 419 patients with de novo myelodysplastic syndromes (MDS) (observation period: 1985-2007). The median age was 71 years (range 24-91 years). Two different scoring systems, the hematopoietic stem-cell transplantation-specific comorbidity index (HCT-CI) and the Charlson comorbidity index (CCI) were applied.

Results: The HCT-CI was found to be a significant prognostic factor for overall survival (OS, P < 0.05) as well as event-free survival (EFS, P < 0.05) in our patients, whereas the CCI was of prognostic significance for OS (P < 0.05), but not for EFS. For AML-free survival, neither the HCT-CI nor the CCI were of predictive value. A multivariate analysis including age, lactate dehydrogenase, ferritin, karyotype, number of cytopenias, French-American-British groups, and comorbidity was applied. Comorbidity was found to be an independent prognostic factor in patients with low- or int-1-risk MDS (P < 0.05) regarding OS and EFS.

Conclusions: Together, our data show that comorbidity is an important risk factor for OS and EFS in patients with MDS.

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