Prognostic features of patients with myelodysplastic syndromes aged < 50 years: update of a single-institution experience.

Abstract

Fewer than 10% of patients with myelodysplastic syndromes (MDS) are younger than 50 years. A series of 91 younger patients (median age 44 years with female prevalence) are reported and compared with elderly patients. Frequent karyotypic changes were trisomy 8 (9.8%) and monosomy 7 (5%). Twenty-three patients had occupational exposure to potential mutagens (benzene and solvents), with a male predominance, higher frequency of refractory cytopenia with multilineage dysplasia (RCMD) (52%) and higher frequency of monosomy 7 (21.7%). At a median follow-up of 72 months, 22 patients (24%) evolved to acute leukemia, with higher frequency being observed among the exposed cohort (39% vs. 19% non-exposed). Unfavorable factors for overall survival were: age > 40 years, > 5% of blasts, trilinear bone marrow involvement and intermediate-high World Health Organization Prognostic Scoring System (WPSS) risk. The present results suggest that younger MDS could be identified as a distinct subset. For patients belonging to the low/intermediate-I risk group, due to a low transformation rate, aggressive approaches should rarely be recommended.

• Authors: Massimo Breccia, Paola Finsinger, Giuseppina Loglisci, Michelina Santopietro, Adriano Salaroli, Alessandra Serrao, Roberto Latagliata, Paola Volpicelli, Luigi Petrucci, Mauro Nanni, Giuliana Alimena
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 53 Issue 12 Pg. 2439-43 (Dec 2012) ISSN: 1029-2403 [Electronic] United States
• PMID: 22647078 (Publication Type: Journal Article)

Chemical References

• Solvents
• Benzene

Topics

• Acute Disease
• Adult
• Aged
• Analysis of Variance
• Benzene (poisoning)
• Cell Transformation, Neoplastic (drug effects, genetics)
• Chromosome Aberrations
• Chromosomes, Human, Pair 7 (genetics)
• Chromosomes, Human, Pair 8 (genetics)
• Disease Progression
• Female
• Humans
• Leukemia (genetics, pathology)
• Male
• Middle Aged
• Monosomy
• Myelodysplastic Syndromes (chemically induced, genetics, pathology)
• Occupational Diseases (chemically induced, genetics, pathology)
• Occupational Exposure
• Prognosis
• Solvents (poisoning)
• Survival Analysis
• Trisomy
• Young Adult