Factors predicting early mortality after new diagnosis of myelodysplastic syndrome: A population-based study

Annie M. Jacobsen, Jenny N. Poynter, Michaela R. Richardson, Phuong L. Nguyen, Betsy Hirsch, Adina Cioc, Michelle A. Roesler, Erica D. Warlick

Research output: Contribution to journalArticle

Abstract

Objective: Little prospective data regarding factors determining patient outcomes in myelodysplastic syndromes (MDS) are available. To establish features of early mortality in MDS, we compare characteristics of patients dying within 1 year of diagnosis with those surviving longer. Methods: We prospectively enrolled adults with a new MDS diagnosis in a population-based case-control study. Logistic regression was used to calculate odds ratios and 95% confidence intervals for potential predictors of early mortality. Subgroup analyses were conducted within the following groups: high-/very-high-risk IPSS-R; very-low-/low-/intermediate-risk IPSS-R; treated patients; and supportive care only patients. Results: We observed early mortality in those with abnormal cytogenetics (OR: 3.36, 95% CI: 1.52-7.46), three or greater cytogenetic abnormalities (OR: 3.48, 95% CI: 1.51-7.99), treatment at a community medical center (versus academic) (OR: 2.55, 95% CI: 1.18-5.47), and with 2-3 concurrent medical comorbidities (OR: 2.14, 95% CI: 1.08-4.22). Similarly, in subgroup analyses, abnormal cytogenetics remained the main predictor of early mortality. Conclusion: Complex cytogenetics and prognostic risk category have been associated with early mortality without intervention. Our data confirm these associations in a large, prospectively followed cohort and highlight the significance of cytogenetic abnormalities and complexity regardless of IPSS-R risk categorization or treatment.

Original languageEnglish (US)
Pages (from-to)56-63
Number of pages8
JournalEuropean Journal of Haematology
Volume103
Issue number1
DOIs
StatePublished - Jul 2019

Keywords

  • myelodysplastic syndrome
  • prospective
  • survival

PubMed: MeSH publication types

  • Journal Article

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