Patients with myelodysplastic syndrome have shorter survival times if they have coexisting medical conditions
Patients with myelodysplastic syndrome (MDS), a group of disorders of the blood-forming stem cells that can transform into acute myelogenous leukemia (AML), survive less long if they have coexisting medical conditions, according to a new study. Previous studies estimate that 3-4 persons per 100,000 are diagnosed with MDS annually, increasing with age to 20 per 100,000 individuals older than 70 years. The University of Texas M.D. Anderson Cancer center researchers analyzed clinical information on all 600 patients with
MDS (67 percent male and 87 percent white) seen at the Center during a 3-year period.
They found that the overall median survival was 18.6 months. However, it was 31.8, 16.8, 15.2, and 9.7 months for individuals with no, mild, moderate, and severe coexisting conditions (measured by the Adult Comorbidity Evaluation-27). In fact, patients with severe coexisting conditions had a 50 percent decrease in survival, independent of age and risk group. Overall, 23 percent of patients had no coexisting conditions, 42 percent had mild, 21 percent had moderate, and 14 percent had severe coexisting conditions. Although MDS transformed to AML in 20 percent of patients, there was no significant association between the severity of coexisting illness and leukemic transformation.
The findings were based on clinical data on all patients with a diagnosis of MDS seen at the M.D. Anderson Cancer Center in Houston from January 2002 through December 2004. The study was funded in part by the Agency for Healthcare Research and Quality (HS16093) to the Houston Center for Education and Research in Therapeutics (CERT). For more information on the CERTs program, visit http://www.certs.hhs.gov.
More details are in "Association of comorbidities with overall survival in myelodysplastic syndrome: Development of a prognostic model," by Kiran Naqvi, M.D., Guilliermo Garcia-Manero, M.D., Sagar Sardesai, M.D., and others in the June 1, 2011, Journal of Clinical Oncology 29(16), 2240-2246.
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