Division of Hematology, Mayo Clinic, Rochester, MN.
Division of Hematology, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2019 Aug;94(8):1467-1474. doi: 10.1016/j.mayocp.2019.02.029.
To study the changes in overall outcome of patients with myelodysplastic syndromes (MDSs) after approval of several treatments.
We identified 54,953 MDS cases in the National Cancer Data Base diagnosed from January 1, 2004, through December 31, 2013, using International Classification of Diseases for Oncology, 3rd edition, codes 9980, 9982-9983, 9985-9987, 9989, 9991-9992. Overall survival and different subgroups were studied over 3 periods of diagnoses (2004-2006, 2007-2009, and 2010-2013).
Median age at diagnosis was 76 years. The most common subtype was MDS-unclassifiable, which represented 55.6% of all cases. We found that males, older patients, patients with refractory anemia with excess blasts, Medicare insurance recipients, and those treated at nonacademic centers had the worse survival (P<.001). Overall survival did not improve over time, except in younger patients (<40 years old).
In the past decade, overall outcome of MDS did not improve despite the advent of new therapies. More studies are needed to understand the impact of newly approved treatments on the outcome of patients with MDS.
研究多种治疗方法获批后骨髓增生异常综合征（MDS）患者总体预后的变化。
我们使用国际肿瘤疾病分类第 3 版（ICD-O-3）代码 9980、9982-9983、9985-9987、9989、9991-9992，从 2004 年 1 月 1 日至 2013 年 12 月 31 日，在国家癌症数据库中确定了 54953 例 MDS 病例。我们研究了诊断后 3 个时期（2004-2006 年、2007-2009 年和 2010-2013 年）的总生存率和不同亚组。
诊断时的中位年龄为 76 岁。最常见的亚型是无法分类的 MDS，占所有病例的 55.6%。我们发现男性、年龄较大的患者、难治性贫血伴原始细胞过多的患者、医疗保险受益人和在非学术中心治疗的患者的生存情况较差（P<.001）。除了年轻患者（<40 岁）外，总体生存率并未随时间推移而改善。
尽管出现了新的治疗方法，但在过去的十年中，MDS 的总体预后并未改善。需要更多的研究来了解新批准的治疗方法对 MDS 患者预后的影响。
