Cause of death in patients with lower-risk myelodysplastic syndrome.
Cause of death in patients with lower-risk myelodysplastic syndrome.
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DOI：
10.1002/cncr.24984
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发表时间：
2010-05-01
期刊：
影响因子：
6.2
通讯作者：
Garcia-Manero, Guillermo
中科院分区：
文献类型：
--
作者：
Dayyani, Farshid;Conley, Anthony P.;Strom, Sara S.;Stevenson, William;Cortes, Jorge E.;Borthakur, Gautam;Fader, Stefan;O'Brien, Susan;Pierce, Sherry;Kantarjian, Hagop;Garcia-Manero, Guillermo
作者最近表明，大多数骨髓增生异常综合征（MDS）患者被国际预后评分系统归类为低风险死亡，而不会转化为急性髓细胞性白血病（AML）。这些患者的死因（COD）还不清楚。确定COD可能有助于指导早期治疗决策。作者回顾性分析了273例死亡的低风险MDS患者的COD，根据国际预后评分系统提交给德克萨斯大学M。D.安德森癌症中心从1980年到2004年。MDS相关死亡定义为感染、出血、转化为AML或疾病进展。其余COD分类为非MDS相关。就诊时的中位年龄为66岁（范围：19-88岁）。总体中位生存期为59周（范围：1-831周）。代表了所有法国-美国-英国白血病分类亚组。国际预后评分系统低和中-1组的百分比分别为21%和79%。最常见的细胞遗传学异常（9%）是del（5 q）。患者仅接受支持性治疗。273例患者中有230例（84%）的COD被确定为MDS相关。最常见的疾病相关的COD是感染（38%），转化为AML（15%）和出血（13%）。最常见的非疾病相关COD是心血管事件（43例患者中有19例）。大多数低风险或中等风险MDS患者将死于与其基础疾病相关的原因。虽然这些结果需要在不同人群中进行验证，但可以考虑在这些患者的管理中进行早期治疗干预，以提高生存率。
The authors have recently shown that a majority of patients with myelodysplastic syndrome (MDS) classified by the International Prognostic Scoring System as lower risk die without transformation to acute myelogenous leukemia (AML). The cause of death (COD) of these patients is not well understood. Identifying the COD could help to guide early therapy decisions. The authors retrospectively analyzed the COD in a cohort of 273 deceased patients with lower-risk MDS according to the International Prognostic Scoring System at presentation to The University of Texas M. D. Anderson Cancer Center from 1980 to 2004. MDS-related death was defined as infection, bleeding, transformation to AML, or disease progression. Remaining CODs were classified as non–MDS-related. Median age at presentation was 66 years (range, 19-88 years). Overall median survival was 59 weeks (range, 1-831 weeks). All French-American-British leukemia classification subgroups were represented. The percentage of International Prognostic Scoring System low and intermediate-1 groups were 21% and 79%, respectively. The most common cytogenetic abnormality (9%) was del(5q). Patients received supportive care only. The COD was identified as MDS-related in 230 of 273 (84%) patients. The most common disease-related CODs were infection (38%), transformation to AML (15%), and hemorrhage (13%). The most frequent non–disease-related COD was cardiovascular events (19 of 43 patients). The majority of patients with low- or intermediate-1 risk MDS will die because of causes related to their underlying disease. Although these results need to be validated in different populations, early therapeutic intervention could be considered in the management of these patients to improve survival.
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影响因子：
6.2
作者：
Ma, Xiaomei;Does, Monique;Mayne, Susan T.
通讯作者：
Mayne, Susan T.
影响因子：
20.3
作者：
Greenberg, P;Cox, C;Bennett, J
通讯作者：
Bennett, J
影响因子：
3.7
作者：
KAPLAN, EL;MEIER, P
通讯作者：
MEIER, P
影响因子：
45.3
作者：
Silverman, LR;Demakos, EP;Holland, JF
通讯作者：
Holland, JF
影响因子：
6.5
作者：
BENNETT, JM;CATOVSKY, D;SULTAN, C
通讯作者：
SULTAN, C