Clinical relevance of extra-hematologic comorbidity in the management of patients with myelodysplastic syndrome

Porta, Matteo Giovanni Della; Malcovati, Luca

doi:10.3324/haematol.2009.005702

Cited by 42 publications

(25 citation statements)

References 16 publications

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“…1 These aberrations can be subdivided into type-I aberrations that result in uncontrolled proliferation, and type-II aberrations that lead to the impaired differentiation of the leukemic cells. [1][2] Recent advances in technology have allowed many novel genetic and molecular abnormalities to be detected, including cryptic translocations (such as NUP98-NSD1), and single gene mutations, occurring for instance in the NPM1, CEBPA, WT1 and MLL-gene (MLL-PTD) which are predominantly found in patients with cytogenetically normal (CN)-AML. 1,3 Newly discovered mutations identified by whole genome sequencing include mutations in the genes encoding for IDH1/ IDH2 and the DNA methyltransferase (DNMT3A) gene, which are rare in pediatric AML.…”

Section: Low Frequency Of Type-i and Type-ii Aberrations In Myeloid Lmentioning

confidence: 99%

“…[1][2] Recent advances in technology have allowed many novel genetic and molecular abnormalities to be detected, including cryptic translocations (such as NUP98-NSD1), and single gene mutations, occurring for instance in the NPM1, CEBPA, WT1 and MLL-gene (MLL-PTD) which are predominantly found in patients with cytogenetically normal (CN)-AML. 1,3 Newly discovered mutations identified by whole genome sequencing include mutations in the genes encoding for IDH1/ IDH2 and the DNA methyltransferase (DNMT3A) gene, which are rare in pediatric AML. [4][5] Children with Down syndrome have an increased risk of developing acute myeloid leukemia (ML-DS).…”

Section: Low Frequency Of Type-i and Type-ii Aberrations In Myeloid Lmentioning

confidence: 99%

“…internal tandem duplications, ITD) and tyrosine kinase domain mutations (TKD), N-RAS and K-RAS, PTPN11, KIT, IDH1/ IDH2, and the DNMT3A genes, as previously described. 1,5 In addition, we investigated the presence of the cryptic translocation NUP98/NSD1 by reverse transcriptase-polymerase chain reaction (RT-PCR). 3 A complete list of investigated regions, primers and PCR condi-…”

Section: Low Frequency Of Type-i and Type-ii Aberrations In Myeloid Lmentioning

confidence: 99%

“…ACE-27 failed to stratify the prognosis in subjects aged 65 years or older, the great majority of MDS patients, as well as in the IPSS low-risk subgroup, 2 in whom comorbidity was reported to considerably increase the risk of death. 1 In addition, the use of a general measure of comorbidity may have led to possible interactions between hematologic disease and comorbid conditions being overlooked.…”

mentioning

confidence: 99%

“…1 Recently, Naqvi and colleagues evaluated the prognostic impact of comorbidity in MDS 2 by using the Adult Comorbidity Evaluation-27 (ACE-27) scale, a measure of comorbidity developed for assessment of patients with solid tumor. 3 They found that comorbidity significantly affects survival and improves the prognostic stratification of patients with MDS.…”

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confidence: 99%

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Clinical evaluation of extra-hematologic comorbidity in myelodysplastic syndromes: ready-to-wear versus made-to-measure tool

Porta¹,

Ambaglio²,

Ubezio³

et al. 2012

Haematologica

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Section: Low Frequency Of Type-i and Type-ii Aberrations In Myeloid Lmentioning

confidence: 99%

Section: Low Frequency Of Type-i and Type-ii Aberrations In Myeloid Lmentioning

confidence: 99%

Section: Low Frequency Of Type-i and Type-ii Aberrations In Myeloid Lmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical evaluation of extra-hematologic comorbidity in myelodysplastic syndromes: ready-to-wear versus made-to-measure tool

Porta¹,

Ambaglio²,

Ubezio³

et al. 2012

Haematologica

Self Cite

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Impact of comorbidities by ACE‐27 in the revised‐IPSS for patients with myelodysplastic syndromes

et al. 2014

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Comorbidities significantly affect the prognosis and outcomes of patients with hematological malignancies. We have previously reported the impact of comorbidities on the International Prognostic Scoring System (IPSS) score. The aim of this study was to determine whether comorbidities continued to have a significant impact when patients were reclassified according to the Revised-IPSS (IPSS-R). The medical records of 600 consecutive myelodysplastic syndrome patients who presented to MD Anderson Cancer Center between January 2002 and June 2004 were reviewed. The Adult Comorbidity Evaluation-27 (ACE-27) was used to assess the severity of comorbid conditions. Four hundred and two (67%) patients were male. Median age at presentation was 66.6 years (17–94). Mean duration of follow-up was 54 months (1–100). Five hundred and two (84%) patients died, and 54 (9%) patients underwent stem cell transplantation. Overall median survival was 16.8 months (1–100). Median survival by IPSS-R was 47, 34, 21, 16, and 6 months for patients in very low, low, intermediate, high, and very high-risk groups, respectively (P < 0.001). The ACE-27 comorbidity score significantly impacted the median survival of patients in the intermediate (P < 0.001), high (P = 0.045), and very high (P = 0.004) IPSS-R groups; but did not significantly impact the median survival in the low (P = 0.11) and very low (P = 0.49) IPSS-R groups. The ACE-27 comorbidity score significantly impacted the median survival of patients ≤65 years (P < 0.001) but did not significantly impact those >65 years (P = 0.18). Assessment of comorbidity may enhance the prognostic ability of the IPSS-R. Am. J. Hematol. 89:509-516, 2014.

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Impact of comorbidities and body mass index on the outcome of polycythemia vera patients

Benevolo

Elli

Bartoletti

et al. 2021

Hematological Oncology

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In 816 patients with 2016 World Health Organization‐defined polycythemia vera (PV) enrolled in a multicenter retrospective study, we investigated the predictive value of Charlson comorbidity index (CCI) and body mass index (BMI) on thrombosis, progression to post‐PV myelofibrosis (PPV‐MF) and survival. Patients were subgrouped according to CCI = 0 (58.1%, no comorbidities) or CCI ≥ 1 (41.9%) and according to normal/underweight (BMI < 25, 54.5%) or overweight/obesity (BMI ≥ 25, 45.5%) at PV diagnosis. BMI was available for 529 patients. Patients with CCI ≥ 1 were older and more frequently presented cardiovascular risk factors compared to patients with CCI = 0 (p < 0.001), while overweight/obese patients were more frequently males (p < 0.001). Cumulative incidence of thromboses with death as competing risk was 13.3% at 10 years. Multivariable analysis with death as competing risk showed that previous thromboses (subdistribution hazard ratio [SHR]: 2.1, p = 0.01) and hypertension (SHR: 1.77, p = 0.04) were significantly associated with a higher thrombotic risk, while BMI ≥ 25 lost statistical significance (SHR: 1.69, p = 0.05) and CCI ≥ 1 was excluded after evaluation of goodness of fit. After a median follow‐up of 6.1 years, progression to PPV‐MF occurred in 44 patients, and 75 patients died. BMI ≥ 25 was associated with a lower probability of progression to PPV‐MF (SHR: 0.38, CI95%: 0.15–0.94, p = 0.04) and better survival (hazard ratio [HR]: 0.42, CI95%: 0.18–0.97, p = 0.04). CCI ≥ 1 did not affect progression to PPV‐MF (p = 0.44) or survival (p = 0.71). The evaluation of CCI and BMI may improve the prognostic definition of PV. In patients with hypertension an accurate evaluation of thrombotic risk is warranted.

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Clinical relevance of extra-hematologic comorbidity in the management of patients with myelodysplastic syndrome

Cited by 42 publications

References 16 publications

Clinical evaluation of extra-hematologic comorbidity in myelodysplastic syndromes: ready-to-wear versus made-to-measure tool

Clinical evaluation of extra-hematologic comorbidity in myelodysplastic syndromes: ready-to-wear versus made-to-measure tool

Impact of comorbidities by ACE‐27 in the revised‐IPSS for patients with myelodysplastic syndromes

Impact of comorbidities and body mass index on the outcome of polycythemia vera patients

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