Reference : A four-parameter index of marrow dysplasia has predictive value for survival in myelo...
Scientific journals : Article
Human health sciences : Hematology
http://hdl.handle.net/2268/6605
A four-parameter index of marrow dysplasia has predictive value for survival in myelodysplastic syndromes.
English
Tassin, Françoise mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie biologique et immuno hématologie >]
Dewé, Walthère [Université de Liège - ULg > Département de pharmacie > Analyse des médicaments - Département de mathématique >]
Schaaf, Nicole mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie biologique et immuno hématologie >]
Herens, Christian mailto [Centre Hospitalier Universitaire de Liège - CHU > > Génétique >]
Ravoet, C. mailto [> > > >]
Albert, Adelin mailto [Université de Liège - ULg > Département des sciences de la santé publique > Informatique médicale et biostatistique - Département de mathématique >]
Beguin, Yves mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Paulus, Jean-Michel mailto [Université de Liège - ULg > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
2000
Leukemia & Lymphoma
Taylor & Francis
36
5-6
485-96
Yes (verified by ORBi)
International
1042-8194
1029-2403
London
United Kingdom
[en] Adult ; Aged ; Bone Marrow/pathology ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes/mortality/pathology/physiopathology ; Predictive Value of Tests ; Prognosis ; Survival Analysis
[en] Marrow dysplasia is a major characteristic of patients with myelodysplastic syndrome (MDS), along with marrow blastosis, cytopenia and cytogenetic anomalies. However, the impact of the degree of marrow dysplasia on survival has not been fully assessed. In this retrospective analysis of 111 patients selected according to the IPSS criteria of MDS diagnosis, the presence or absence of 21 dysplasia characteristics recognizable in bone marrow smears stained by the May-Grunwald-Giemsa method was correlated with patient survival. Using Cox proportional hazards regression analysis, megaloblastosis (MEGALO), neutrophil agranularity (AGRAN) and hypogranularity (HYPOGRAN) were highly significant predictors (p < 0.005), and Pelger-Huet anomaly (PELGHUET) a significant predictor (p = 0.05), of patient survival. The regression analysis yielded a dysplasia-based risk index (DI) where DI = 1.26 MEGALO + 0.82 AGRAN - 1.08 HYPOGRAN + 0.45 PELGHUET. The two subgroups of 60 and 47 patients with DI < or = 0 and > 0 showed highly significant differences in median survivals (2.6 vs 1.1 yrs; p <0.0001). Multivariate analysis further showed that DI offered additional predictive power that was independent of that provided by the IPSS (p=0.002 and 0.001 respectively). Analysis of survival curves stratified for IPSS and DI showed that the additional predictive power offered by inclusion of the DI essentially concerned the IPSS low/INT-1 risk categories. Further stratification for age did not improve survival prediction. The data indicate that a set of 4 dysplasia parameters can offer some prediction for survival of MDS patients in addition to that provided by the IPSS. Further multicenter studies should aim at including some form of evaluation of the degree of dysplasia in prognostic systems.
http://hdl.handle.net/2268/6605

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