Prognostic Factors and Life Expectancy in Myelodysplastic Syndromes Classified According to WHO Criteria: A Basis for Clinical Decision Making

Abstract

These data show that the WHO classification of MDSs has a relevant prognostic value. This classification, along with cytogenetics, might be useful in decisions regarding transplantation. MDS with isolated erythroid lineage dysplasia identifies a subset of truly low-risk patients, for whom a conservative approach is advisable.

Prognostic relevance of anemia in myelodysplastic syndromes

“…Cardiovascular disease may have a relevant impact on the outcome of patients with refractory anemias. In agreement with these findings, we found that transfusion-dependent patients have an increased risk of cardiac failure [3]. Efforts to evaluate the contribution of non-hematological comorbidity on the prognosis of anemic patients with myelodysplastic syndrome are warranted.…”

“…However, when accounting for blast percentage using WHO categories, the only other IPSS variable adding prognostic information was found to be cytogenetics. We also found that transfusion dependency had a significant effect on survival in multivariable analysis [3]. On the basis of this and other observations [1,8], we concluded that transfusion dependency could be considered an independent indicator of the severity of the disease and an independent prognostic factor.…”

“…In our study on the prognostic significance of the WHO classification, [3] we found that the IPSS retained significance within the WHO subgroups. However, when accounting for blast percentage using WHO categories, the only other IPSS variable adding prognostic information was found to be cytogenetics.…”

“…The World Health Organization (WHO) classification of myeloid neoplasms [2] provides clinicians with a very useful tool for defining the different subtypes of myelodysplastic syndromes. This classification is not only useful for diagnostic purposes but also has a relevant prognostic value, and it can therefore be used to facilitate clinical decision-making in the individual patient [3,4]. Among patients with myelodysplastic syndromes without excess blasts, in particular, the isolated involvement of the erythroid lineage as compared with bior tri-lineage marrow dysplasia is associated with a significantly better prognosis in terms of both overall survival and leukemia-free survival.…”

Iron status and treatment modalities in transfusion-dependent patients with myelodysplastic syndromes

“…Myelodysplastic syndromes (MDS) are a heterogeneous group of bone marrow disorders characterized by cytopenias due to ineffective production of normal mature blood cells, with course of disease and prognosis dependent on subtype [1,2,3,4,5,6,7,8,9]. Up to 30% of patients progress to acute myelogenous leukemia (AML); while up to 65% of nonprogressing MDS patients will develop progressive cytopenia(s) [5].…”