Acute Myeloid Leukemia progression in Myelodysplastic Syndromes, results from the Argentine registry

ENRICO, ALICIA; KORNBLIHTT, LAURA; MILONE, JORGE; ARBELBIDE, JORGE; FANTL, DOROTEA; ALFONSO, GRACIELA; IASTREBNER, MARCELO; FLORES, GABRIELA; CORREA, WALTER A; NEGRI ARANGUREN, PEDRO; CELEBRIN, LUCIA; AGRA, MARCELA; WATMAN, NORA; BASQUIERA, ANA L; BESTACH, YESICA; BENGIÓ, RAQUEL; LARRIPA, IRENE; BELLI, CAROLINA

Milan

Congreso; 19th Congress of the European Haematology Association; 2014

EHA

Background: At least, one third of patients with Myelodysplastic Syndromes (MDS) develops Acute Myeloid Leukemia (AML) at any time of the follow-up. This subgroup of patients depict clinical and laboratory features, specific MDS subtype, and especially poor prognosis. Aims: To describe and analyze clinical features of adult MDS patients that had progressed to AML Methods: This is a multicenter retrospective study of 197 (23%) adult MDS patients that progressed to secondary AML (s-AML), from a database of 840 patients diagnosed from 1981 to 2013. Data belong to the MDS Registry sponsored by the Argentinean Society of Hematology and to a previous multicenter study. Informed Consent was required. Patients were classified following FAB and WHO criteria and 13 patients presented with secondary MDS. The median age was 64 (17-89) years with 74% above 60 years, a male/female (123/74) ratio of 1.7. During the follow-up, with a median overall survival of 14.3 months, 173 (88%) died. BM transplanted patients were censored till the moment of the procedure. Using a log-rank test and Kaplan-Meier, we performed a univariate analysis to examine the effects of age at MDS diagnosis (limit of 70 years), gender, haematological parameters and, IPSS, WPSS and IPSS-R scores on time to Leukemia transformation (TTL) and on the overall survival (OS). Results: FAB classification was evaluable in 184 patients distributed into: RA 37 (20%), RARS 7 (4%), RAEB 71 (39%), RAEB-T 39 (21%), CMML 30 (16%). WHO classification was evaluable in 134 patients: RCUD/5q- 10 (7%), RCMD 34 (25%), RAEB-1 33 (25%), and RAEB-2 57 (43%). Age (limit of 70 years), percentage of bone marrow blast (0-20), hemoglobin level (limit of 10 g/dL), platelets (limit of 100000 /μL) and neutrophil count (limit of 800 /μL), LDH level, cytogenetic group of risk (according to the IPSS-R), and red blood cell transfusion requirements were significant predictive variables for prognosis (Kaplan- Meier and Long-Rank test, p