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. 2015 Aug;39(8):846-52.
doi: 10.1016/j.leukres.2015.05.007. Epub 2015 Jun 22.

Age and comorbidities deeply impact on clinical outcome of patients with myelodysplastic syndromes

E Balleari  1 , C Salvetti  2 , L Del Corso  2 , R Filiberti  3 , A Bacigalupo  2 , A Bellodi  2 , G Beltrami  2 , M Bergamaschi  2 , G Berisso  4 , T Calzamiglia  5 , A M Carella  2 , M Cavalleri  6 , A Da Col  2 , S Favorini  2 , G L Forni  7 , R Goretti  8 , M Miglino  2 , L Mitscheuning  2 , E Molinari  2 , O Racchi  9 , M Scudeletti  6 , R Tassara  10 , M Gobbi  2 , R Lemoli  2 , M Clavio  2
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Age and comorbidities deeply impact on clinical outcome of patients with myelodysplastic syndromes

E Balleari et al. Leuk Res. 2015 Aug.

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.

Keywords: Comorbidity; Elderly; Myelodysplastic syndromes; Prognosis.

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