학술논문
Prognostic impact of micromegakaryocytes in primary myelodysplastic syndromes.
Document Type
Article
Author
Saumell, Sílvia; Fernández-Serrano, Miranda; Mesa, Alba; López-Cadenas, Félix; Arenillas, Leonor; Alfonso, Ana; Montoro, Maria Julia; Molero, Antonieta; Leoz, Pilar; Riego, Victoria; Gallur, Laura; Salamero, Olga; Navarrete, Mayda; Tazón-Vega, Bárbara; Ortega, Margarita; Reig, Òscar; Roué, Gaël; Calvo, Xavier; Prosper, Felipe; Díez-Campelo, María
Source
Subject
*MYELODYSPLASTIC syndromes
*ACUTE myeloid leukemia
*OVERALL survival
*MULTIVARIATE analysis
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Language
ISSN
1042-8194
Abstract
Micromegakaryocytes (microMKs) are considered a myelodysplastic feature of myeloid neoplasms in adults, with an adverse prognosis connotation. However, this notion in MDS has not been well proved. In our cohort of 287 MDS, patients with microMKs showed lower overall survival (OS) (HR, 2.12; 95% CI, 1.47–3.06; p = 0.000036) and higher risk of acute myeloid leukemia (AML) evolution (HR, 4.8; 95% CI, 2.9–11.01; p = 0.00021). Results were validated with an independent cohort. In multivariate analysis, the presence of microMKs maintained its independent association with OS (HR, 1.54, 95% CI, 1.13–2.1, p = 0.0059) and AML transformation (HR, 2.28, 95% CI, 1.2–4.4, p = 0.014). Moreover, by adding 1 point to the IPSS-R score in patients with microMKs, we improved the IPSS-R accuracy. Interestingly, adding that 1-point, 29% of intermediate IPSS-R risk group patients were upgraded to the high-risk group. In summary, we confirmed that the presence of microMKs implies worse outcomes in MDS and suggested a modification improving IPSS-R. [ABSTRACT FROM AUTHOR]