骨髓增生异常综合征患者合并疾病的预后意义研究

OBJECTIVE: To discuss the impact of comorbidities on the outcomes of patients with MDS. METHODS: The clinical characteristics of 676 MDS patients with detailed comorbidities evaluations was analyzed retrospectively. RESULTS: There were 395/676 cases (58.4%) with comorbidities (group 1), 281/676 cases (41.6%) without (group 2). Significant differences were seen in the distribution of age (≥60 y), bone marrow blasts, abnormal karyotype, WHO 2008 subtypes and IPSS-R risk cohorts (P<0.05) between the two groups. While gender, HGB concentrations, WBC levels, platelet levels and serum ferritin were not significantly different (P>0.05). Independent prognostic significance of comorbidities was seen in both uni-variate and multi-variate analyses (P<0.001). According to MDS-specific comorbidity index (MDS-CI), the median survival were 32 (1–153) months, 19 (2–85) months and 13 (1–37) months in the low-risk, intermediate-risk and high-risk cohorts respectively, while 96 (1–166) months in cohorts without any comorbidities, of which significant differences were seen (P<0.001). The MDS-CI allowed further stratification in the IPSS-R low-risk, intermediate-risk and high-risk cohorts (P<0.001). CONCLUSION: Comorbidities provides prognostic stratification independently of IPSS-R for MDS patients.