Prognostic impact of severe thrombocytopenia in low-risk myelodysplastic syndrome

✍ Scribed by 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; on behalf of the Spanish Myelodysplastic Syndrome Registry

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 369 KB
• Volume: 117
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/cncr.26173

✦ Synopsis

Abstract

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.