The prognostic value of dysplasia features in myelodysplastic syndromes / 白血病·淋巴瘤

ABSTRACT

Objective To analyze the characteristics of dysplasia in patients with myelodysplastic syndromes (MDS),and identify the risk factors for evolution of MDS to acute leukemia.Methods According to the WHO criterion 2008 of MDS,98 cases were included.As the characteristics of dysplasia,cell morphology,cytogenetics and flow cytometry were analyzed in these patients.Results To the last follow-up,27 of 98 patients transformed to acute myeloid leukemia,including M2 (15 cases),M4 (10 cases),M6 (2 cases).Patients with abnormal Pelger-Hu(e)t had significantly higher risk for evolution of MDS to leukemia,when compared to those without Pelger-Hu(e)t (23/67 vs 4/36,x2 =4.87,P =0.03).Auer corpuscle and small nuclear pathological were also the risk factors of developing to leukemia (19/37 vs 8/61,x2 =16.87,P =0.000; 21/57vs 6/46,x2 =9.14,P =0.003,respectively).37 patients died,the median suvival time was 26 months (95 ％ CI 13-38) for patients with abnorrnal Pelger-Hu(e)t,19 months (95 ％ CI 11-26) for patients with Auer corpuscle,13 months (95 ％ CI 6-19) for patients with small nuclear pathology,respectively (x2 =11.05,13.04,21.05,P =0.001,0.000,0.000).Conclusion Abnormal Pelger-Hu(e)t,Auer corpuscle and small nuclear pathology are indentified as the risk factors for evolution of MDS to leukemia,and they are the infavorable predictors of survival.