Risk factors of mydelodysplastic syndromes (MDS) remain largely unknown. We conducted a hospital-based case-control study consisting of 403 newly diagnosed MDS patients according to World Health Organization classification and 806 individually gender and age-matched patient controls from 27 major hospitals in Shanghai, China, to examine relation of lifestyle, environmental, and occupational factors to risk of MDS. The study showed that all MDS (all subtypes combined) risk factors included anti tuberculosis drugs [odds ratio (OR)
IntroductionMyelodysplastic syndromes (MDS) represent a heterogeneous group of neoplastic clonal stem cell disorders characterized by clinical presentations of anemia, thrombocytopenia, and leucopenia. MDS may be categorized into subtypes according to histological, immunological, and genetic characteristics. MDS was usually diagnosed by French-American-British (FAB) classification with subtypes including refractory anemia (RA), RA with ringed sideroblasts (RARS), RA with excess of blasts (RAEB), RAEB in transformation (RAEB-T), and chronic myelomonocytic leukemia (CMML) [1]. Since its publication in 2001, World Health Organization (WHO) classification for MDS has become widely adopted [2]. In the WHO MDS system, blast cutoff is less than 20% compared to 30% in FAB system. Additional WHO MDS subtypes include refractory cytopenia with multiple dysplasia (RCMD), MDS with isolated del(5q), and MDS unclassifiable (MDS-u) and the WHO MDS system does not include CMML [3].Secondary MDS is usually resulted from radiation and chemotherapy. Little is known about the etiology of primary or de novo MDS. Most previous studies on MDS risk factors focused on FAB MDS [4][5][6]. Here, we report a large hospital-based case-control study of 403 WHO MDS cases and 806 age and sex-matched controls in a Chinese population to assess effects of lifestyle, environmental, and occupational factors on MDS development.