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Prognostic impact of severe thrombocytopenia in low‐risk myelodysplastic syndrome
Author(s) -
GonzalezPorras Jose Ramon,
Cordoba Iris,
Such Esperanza,
Nomdedeu Benet,
Vallespi Teresa,
Carbonell Felix,
Luño Elisa,
Ardanaz Maite,
Ramos Fernando,
Pedro Carme,
Gomez Valle,
de Paz Raquel,
SanchezBarba Mercedes,
Sanz Guillermo F.,
del Cañizo and Consuelo
Publication year - 2011
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.26173
Subject(s) - medicine , international prognostic scoring system , hazard ratio , incidence (geometry) , myelodysplastic syndromes , confidence interval , proportional hazards model , risk factor , gastroenterology , surgery , bone marrow , physics , optics
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.