Department of Haematology, Huashan Hospital, Fudan University, 12 Wulumuqi Road central, Shanghai, China.
Ann Hematol. 2010 Jul;89(7):671-9. doi: 10.1007/s00277-010-0912-6. Epub 2010 Feb 24.
The prognostic value of karyotype in patients with myelodysplastic syndrome (MDS) is generally appreciated. However, the factors that are predictive of prognosis of patients with abnormal karyotypes are not known. In this study, we evaluated the prognostic value of International Prognostic Scoring System (IPSS) and World Health Organization classification-based prognostic scoring system (WPSS) in 164 adult MDS patients with abnormal karyotypes. We also analyzed the prognostic relevance of mean corpuscular volume (MCV) in these patients. We found that both IPSS and WPSS had strong prognostic value in patients with abnormal karyotypes (P < 0.001, P < 0.001). Furthermore, we observed the significant differences in the survival of patients with abnormal karyotypes based on MCV stratification: The median survival of patients with macrocytosis was 31.0 months, significantly longer than the 16.5-month median survival time of patients with MCVs of less than 100 fl (P = 0.001). Multivariate analysis revealed that lower level of hemoglobin (P = 0.012, HR = 6.83), higher level of marrow blasts (P < 0.001, HR = 1.93), complex karyotype (P = 0.001, HR = 3.32), and MCV of less than 100 fl (P = 0.026, HR = 1.75) were independent risk factors that affected the survival of patients with abnormal karyotypes.
骨髓增生异常综合征（MDS）患者的核型预后价值通常得到认可。然而，具有异常核型的患者的预后预测因素尚不清楚。在这项研究中，我们评估了国际预后评分系统（IPSS）和基于世界卫生组织分类的预后评分系统（WPSS）在 164 例异常核型成人 MDS 患者中的预后价值。我们还分析了这些患者平均红细胞体积（MCV）的预后相关性。我们发现，IPSS 和 WPSS 在异常核型患者中均具有很强的预后价值（P<0.001，P<0.001）。此外，我们观察到 MCV 分层的异常核型患者的生存存在显著差异：大细胞性患者的中位生存期为 31.0 个月，明显长于 MCV<100fl 的患者的 16.5 个月中位生存期（P=0.001）。多变量分析显示，较低的血红蛋白水平（P=0.012，HR=6.83）、较高的骨髓原始细胞比例（P<0.001，HR=1.93）、复杂核型（P=0.001，HR=3.32）和 MCV<100fl（P=0.026，HR=1.75）是影响异常核型患者生存的独立危险因素。
