INFLUENCE OF ACUTE MYELOID LEUKEMIA PROGRESSION ON THE PROGNOSIS OF 831 PATIENTS WITH MYELODYSPLASTIC SYNDROMES FROM THE ARGENTINE DATABASE

ENRICO, ALICIA; BESTACH, YESICA; FLORES, GABRIELA; ARBELBIDE, JORGE; SERALE, CAMILA; NOVOA, VIVIANA; CRISP, RENÉE; RIVAS, MARÍA M; LARRIPA, IRENE; BELLI, CAROLINA

Clinical Lymphoma, Myeloma & Leukemia

Elsevier Ltd

Lugar: New York; Año: 2017 vol. 17 p. 743 - 752

2152-2650

BACKGROUND: A large group of the patients with Myelodysplastic Syndromes(MDS) die from causes intrinsic to the bone-marrow failure. One-third of patients progresses to Acute Myeloid Leukemia (AML), which is associated with an extremely poor outcome and a short survival. Our objectives were to analyze prognostic variables and scoring systems in the attempt to access the influence of progression on the overall survival of MDS patients. PATIENTS: This was a retrospective analysis of 831 MDS patients including those from to the Argentine Registry. RESULTS: Onehundred-and-fifty-eight (19.0%) patients underwent transformation with a medianoverall survival of 17.9 months from diagnosis and 3.5 months after progression. The survival of patients with adverse karyotypes or with higher risk, according to the IPSS-R or WPSS, was not affected upon comparison of patients with or without evolution to AML (p>0.05). On the other extreme, the survival of lower risk patients was significantly reduced in those patients who progressed (p< 0.001), being younger (p= 0.024) than those who died of non-AML related causes. The intermediate-risk patients were heterogeneously distributed; however, an upgrade from a lower IPSS-R to a higher WPSS-Hb risk category was associated with a worst outcome, not affected by progression (p= 0.420), with a median event free survival of 16 months. CONCLUSION: The use of IPSS-R and WPSS systems simultaneously may help pointing out those patients that would require a more aggressive treatment; nevertheless, more efforts are need to improve identification of those lower risk patients whose survival is significantly reduced by AML progression.