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

描述（由申请人提供）：这是一个癌症预防，控制，行为和人口科学职业发展奖使用K 07机制的应用程序。该奖项的目的是为马小梅博士提供受保护的时间和额外的培训和指导，使她能够成为一名独立的研究者。骨髓增生异常综合征（MDS）是一组克隆性增殖性骨髓疾病，导致骨髓生成障碍和外周血细胞减少。虽然MDS长期以来一直被认为是白血病前期疾病，但由于其克隆性质，最好将其视为癌症的一种形式。尽管MDS的预后差，发病率可能增加，但对病因和影响生存和生活质量的因素的了解非常有限，这可能是由于，至少部分是由于疾病的生物异质性。2003-2004年，美国国会将MDS确定为未充分研究，并敦促NCI和其他机构进一步开展MDS研究。基于1,600多例原发性MDS患者的生物学和临床特征的详细信息，我们建议1）将MDS病例分类为更同质的亚组; 2）说明不同亚组中的病例是否具有不同的既往暴露模式（例如家族史、病史、吸烟、饮酒、接触职业和环境化学品以及锻炼）; 3）描述不同亚组病例的生存模式; 4）评估哪些因素决定生存期; 5）评估生存MDS患者的健康相关生活质量。与以往的研究相比，本研究具有样本量大、数据全面等特点。由于以前的研究提供了大量的数据，本研究只需要很少的资源来收集额外的数据。在研究过程中，马博士将接受癌症相关生活质量研究、饮食因素评估以及空间统计方法和生物信息学应用方面的培训。该研究的结果将促进对MDS生物学异质性的认识，有助于指导未来的MDS病因学研究，提供对生存决定因素的深入了解，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，该奖项将为有前途的初级研究人员提供一个独特的机会，在癌症研究的职业发展。

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.