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Prognostic impact of severe thrombocytopenia in low-risk myelodysplastic syndrome.
MedLine Citation:
PMID:  21638279     Owner:  NLM     Status:  Publisher    
BACKGROUND: Thrombocytopenia is very common in myelodysplastic syndrome (MDS); however, its clinical impact in low-risk patients remains controversial. METHODS: The authors analyzed the incidence and prognostic significance of thrombocytopenia at diagnosis in 2565 de novo MDS patients included in the Spanish MDS Registry. RESULTS: Thrombocytopenia (platelet count <100 × 10(9) /L) was identified in 842 patients (32.8%). Severe thrombocytopenia (platelet count <30 × 10(9) /L) was observed in 7.1% of patients and was significantly associated with a higher-risk World Health Organization subtype (P = .026) and intermediate-2/high-risk International Prognostic Scoring System (IPSS) score (P = .046). Severe thrombocytopenia was the most important prognostic factor and had negative effects on the low/intermediate-1 risk group. Median overall survival of patients with a platelet count <30 and ≥30 × 10(9) /L was 16 months and 71 months, respectively (hazard ratio, 4.66; 95% confidence interval, 2.74-7.90; P < .0001). The negative effect of severe thrombocytopenia in low/intermediate-1 risk patients was caused by increased risk of bleeding. CONCLUSIONS: MDS patients with low/intermediate-1 IPSS risk score and severe thrombocytopenia should no longer be regarded as low risk, and must be considered for disease-altering approaches at diagnosis. Cancer 2011;. © 2011 American Cancer Society.
Jose Ramon Gonzalez-Porras; Iris Cordoba; Esperanza Such; Benet Nomdedeu; Teresa Vallespi; Felix Carbonell; Elisa Luño; Maite Ardanaz; Fernando Ramos; Carme Pedro; Valle Gomez; Raquel de Paz; Mercedes Sanchez-Barba; Guillermo F Sanz; And Consuelo Del Cañizo;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-2
Journal Detail:
Title:  Cancer     Volume:  -     ISSN:  1097-0142     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Cancer Society.
Salamanca University Hospital, Salamanca, Spain.
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