Myelodysplastic Syndromes: Previous Exposures, Survival, and Quality of Life

描述(申请人提供)：这是一份使用K07机制的癌症预防、控制、行为和人口科学职业发展奖的申请。该奖项的目的是为马晓梅博士提供受保护的时间以及额外的培训和指导，以便她能够成为一名独立的调查人员。骨髓增生异常综合征(MDS)是一组克隆性增殖性骨髓疾病，导致骨髓增生异常和外周血细胞减少。尽管MDS长期以来一直被认为是一种白血病前期疾病，但由于其克隆性，它更容易被视为一种癌症。尽管MDS的预后很差，发病率可能会增加，但对其病因以及影响生存和生活质量的因素的了解非常有限，这可能至少部分是由于这种疾病的生物学异质性。在2003-2004年间，美国国会认定MDS研究不足，并敦促NCI和其他机构进一步研究MDS。基于1,600多名原始MDS患者的详细生物学和临床特征信息，我们建议1)将MDS病例分类为更同质性的亚组；2)说明不同亚组中的病例是否有不同的既往暴露模式(例如，家族史、病史、吸烟、饮酒、职业和环境化学品暴露以及锻炼)；3)描述不同亚组中病例的生存模式；4)评估哪些因素决定生存时间；以及5)评估存活MDS患者中与健康相关的生活质量。与以往的研究相比，本研究的显著特点是样本量大，数据全面。由于先前研究的大量数据可用，在本研究中只需要很少的资源来收集额外的数据。在研究过程中，马博士将接受与癌症相关的生活质量研究、饮食因素评估以及空间统计方法和生物信息学的应用方面的培训。这项研究的发现将促进对MDS生物异质性的认识，有助于指导未来MDS的病因学研究，提供对生存决定因素的洞察，并更好地了解MDS幸存者的生活质量和影响生活质量的因素。此外，该奖项将为一名有前途的初级研究员提供一个在癌症研究领域进行职业发展的独特机会。

DESCRIPTION (provided by applicant): This is an application for a Cancer Prevention, Control, Behavioral and Population Sciences Career Development Award using the K07 mechanism. The purpose of the award is to provide Dr. Xiaomei Ma protected time and additional training and mentoring so she could become an independent investigator. The myelodysplastic syndromes (MDS) are a group of clonal proliferative bone marrow disorders resulting in dysmyelopoiesis and peripheral blood cytopenias. Although MDS has long been considered a pre-leukemic disorder, it is better viewed as a form of cancer because of the clonal nature. Despite MDS's poor prognosis and a likely increasing incidence, understanding about the etiology and factors affecting survival and quality of life is very limited, which may be due, at least in part, to the biological heterogeneity of the disease. In 2003-2004, the US congress identified MDS as understudied and urged that the NCI and other agencies to further MDS research. Building upon a large series of more than 1,600 primary MDS patients with detailed information on biological and clinical characteristics, we propose to 1) classify MDS cases into subgroups that are more homogeneous; 2) illustrate whether cases in different subgroups have distinct patterns of previous exposures (e.g. family history, medical history, cigarette smoking, alcohol drinking, exposure to occupational and environmental chemicals, and exercise); 3) describe the survival patterns of cases in different subgroups; 4) evaluate which factors determine the duration of survival; and 5) assess the health-related quality of life among surviving MDS patients. Compared with previous studies, the proposed research is distinguished by a remarkably large sample size and the comprehensiveness of data. Because of the availability of extensive data from previous research, only few resources are needed for additional data collection in this study. During the course of the study, Dr. Ma will be trained in cancer-related quality of life research, assessment of dietary factors, and application of spatial statistics methods and bioinformatics. Findings from the study will advance the knowledge about the biological heterogeneity of MDS, help guide future etiologic studies of MDS, offer insight into the determinants of survival, and better understand the quality of life of MDS survivors and factors affecting the quality of life. In addition, the award will provide a promising junior investigator a unique opportunity for career development in cancer research.