Predictors of myelodysplastic syndrome in Minnesota

描述（由申请人提供）：骨髓增生异常综合征（MDS）是造血系统的异质性破坏，可导致约1/3病例发生急性髓性白血病（AML）。MDS于2001年开始向监测、流行病学和最终结果计划报告。据估计，美国每年新诊断的MDS病例约为1万例，与恶性胶质瘤的数量相似。明尼苏达州是MDS发病率较高的地区之一。除了与< 5%的MDS相关的其他癌症的化疗和放射治疗外，对病因知之甚少。在进行的少数研究中（大多数<200例和/或基于临床），有一个建议的作用，职业暴露，吸烟和其他一些生活方式因素，其中许多是类似的与AML相关。我们提出了一个新的基于人群的研究MDS在明尼苏达州，利用我们正在进行的成人髓性白血病研究，在2010年初结束的问卷和基础设施。在4年半的时间内（2010年4月1日至2014年10月31日），共入组705例MDS病例和705例频率匹配的人群对照。除了评估上述潜在风险因素外，我们还将通过整合我们成人髓性白血病研究的数据，通过中心病理学审查MDS亚型来探索风险因素。我们还将确定AML和MDS共同的环境或其他外源性风险因素与不同的风险因素。此外，我们将探讨是否有风险因素更常见于MDS病例，有进展为AML的风险，其中包括新的预后评分系统。最后，我们将收集MDS病例和对照的唾液，用于未来的遗传易感性研究。这项研究将是迄今为止进行的最大规模的基于人群的MDS研究。随着成功的基础设施的整合，以及与类似的现有髓系白血病研究进行比较的能力，我们处于独特的地位，可以回答有关MDS的重要病因学问题。该提案的重要性还涉及成人AML的潜在预防策略，这对公共卫生具有重要影响。

DESCRIPTION (provided by applicant): Myelodysplastic syndrome (MDS) is a heterogeneous disruption of the hematopoietic system that can lead to the development of acute myeloid leukemia (AML) in about 1/3 of cases. MDS became reportable to the Surveillance, Epidemiology and End Results program in 2001. It is estimated that about 10,000 MDS cases are newly diagnosed each year in the United States, which is similar to the number of malignant gliomas. Minnesota has one of the higher incidence rates of MDS. With the exception of chemotherapy and radiation treatment for other cancers, which is associated with < 5% of MDS, little is known about causes. Of the few studies conducted (mostly <200 cases and/or clinic-based), there is a suggestion of a role for occupational exposures, cigarette smoking, and some other lifestyle factors, many of which are similar to those associated with AML. We are proposing a new population-based study of MDS in Minnesota that utilizes the questionnaire and infrastructure of our ongoing adult myeloid leukemia study that concludes in early 2010. A total of 705 MDS cases and 705 frequency-matched population controls will be enrolled over a 4 1/2 year period (April 1, 2010 - October 31, 2014). In addition to evaluating potential risk factors such as those described above, we will explore risk factors by central pathology reviewed subtypes of MDS by integrating data from our adult myeloid leukemia study. We will also determine those environmental or other exogenous risk factors that are common to AML and MDS versus those risk factors that are distinct. Additionally, we will explore whether there are risk factors more common to MDS cases that are at risk of progressing to AML, which includes the novel incorporation of prognostic scoring systems. Finally, we will collect saliva from MDS cases and controls for future genetic susceptibility studies. This study will be the largest population-based study of MDS conducted to date. With the incorporation of a successful infrastructure, and the ability to make comparisons with a similar existing study of myeloid leukemia, we are uniquely positioned to answer important etiological questions regarding MDS. The significance of this proposal also relates to potential prevention strategies for adult AML, which has important public health implications.