Neukirchen Judith, Nachtkamp Kathrin, Schemenau Jennifer, Aul Carlo, Giagounidis Aristoteles, Strupp Corinna, Kuendgen Andrea, Kobbe Guido, Haas Rainer, Germing Ulrich
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Duesseldorf, Germany.
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Duesseldorf, Germany.
Leuk Res. 2015 Jul;39(7):679-83. doi: 10.1016/j.leukres.2015.04.001. Epub 2015 Apr 15.
During the last years, more and more treatment modalities are available for MDS patients. Therefore, we were interested if this is reflected in an improvement of the outcome of the patients. We analyzed the survival and rate of leukemic progression of 4147 patients from the Duesseldorf MDS registry diagnosed during the last 30 years and found an improvement of survival in those patients diagnosed after 2002 (30 vs. 23 months, p<0.0001). In detail, the improvement of the prognosis was restricted to high-risk MDS patients diagnosed between 2002 and 2014 in comparison to the patient group diagnosed between 1982 and 2001 (19 vs. 13 months, p<0.001), whereas the prognosis of low-risk MDS patients did not change significantly. The improvement of survival was still measurable after exclusion of RAEB-t patients and of those, that received an allogeneic stem cell transplantation. In line with this finding, we found a lower AML progression rate in the later diagnosed group. Unfortunately, we could not identify a clear reason for this finding but rather a multifactorial cause should be assumed. As death due to bleeding complications and infections was significantly lower, an improvement of BSC may be one of the underlying causes.
在过去几年中，骨髓增生异常综合征（MDS）患者有了越来越多的治疗方式。因此，我们想知道这是否反映在患者预后的改善上。我们分析了来自杜塞尔多夫MDS登记处的4147例在过去30年中确诊的患者的生存情况和白血病进展率，发现2002年后确诊的患者生存情况有所改善（30个月对23个月，p<0.0001）。具体而言，与1982年至2001年确诊的患者组相比，2002年至2014年确诊的高危MDS患者预后有所改善（19个月对13个月，p<0.001），而低危MDS患者的预后没有显著变化。排除转化中的原始细胞过多难治性贫血（RAEB-t）患者和接受异基因干细胞移植的患者后，生存改善情况仍然可测。与此发现一致，我们发现在较晚确诊的组中急性髓系白血病（AML）进展率较低。不幸的是，我们无法确定这一发现的明确原因，而应假定是多因素导致的。由于出血并发症和感染导致的死亡显著降低，最佳支持治疗（BSC）的改善可能是潜在原因之一。
