Shi Z X, Qin T J, Xu Z F, Huang H J, Li B, Qu S Q, Hu N B, Pan L J, Liu D, Cai Y N, Zhang Y D, Xiao Z J
Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, the State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2020 Jan 14;41(1):28-33. doi: 10.3760/cma.j.issn.0253-2727.2020.01.006.
To explore the prognostic effects of mean corpuscular volume (MCV) in patients with myelodysplastic syndromes (MDS) . 321 newly diagnosed, untransfused primary MDS patients who administered from December 2009 to December 2017 were enrolled. The association of MCV with prognosis and several clinical features and genetic mutations were analyzed. Patients were divided into MCV≤100 fl (=148) and MCV>100 fl (=173) cohorts. Median overall survival of patients with MCV≤100 fl was shorter than their counterparts (27 months 72 months, <0.001) . In subgroup analysis, MCV≤100 fl patients had worse survivals in bone marrow blast <5% cohort (34 months not reached, =0.002) , but not so in ≥5 % cohort (17 months 20 months, =0.078) . MCV≤100 fl was still an independent adverse variable (=1.890, 95% 1.007-3.548, =0.048) after adjusting for clinical and laboratory variables and mutation topography in bone marrow blasts<5% cohort. In bone marrow blasts<5% cohort, patients with MCV≤100 fl had higher hemoglobin levels [90 (42-153) g/L 78.5 (28-146) g/L, =0.015].The proportions of Revised International Prognostic Scoring System (IPSS-R) high/very high risks and poor/very poor IPSS-R karyotypes were higher in MCV≤100 fl cohort (28.8% 10.8%, =0.003; 24.7% 12.9%, =0.049) . MCV≤100 fl cohort had more genetic mutations than those with MCV>100 fl though without significance (0.988 0.769, =0.064) . Mutated SF3B1 was less frequently in MCV≤100 fl cohort (4.7% 15.4%, =0.018) . MCV≤100 fl was an independent adverse variable after adjusting for clinical and laboratory variables and mutation topography in MDS patients with bone marrow blasts<5%.
为探讨平均红细胞体积（MCV）对骨髓增生异常综合征（MDS）患者预后的影响。纳入了2009年12月至2017年12月期间收治的321例新诊断、未输血的原发性MDS患者。分析了MCV与预后、多种临床特征及基因突变之间的关联。患者被分为MCV≤100 fl组（n = 148）和MCV>100 fl组（n = 173）。MCV≤100 fl患者的中位总生存期短于MCV>100 fl的患者（27个月对72个月，P<0.001）。亚组分析中，在骨髓原始细胞<5%的亚组中，MCV≤100 fl的患者生存期较差（34个月对未达到，P = 0.002），但在骨髓原始细胞≥5%的亚组中并非如此（17个月对20个月，P = 0.078）。在骨髓原始细胞<5%的亚组中，校正临床和实验室变量以及骨髓原始细胞中的突变图谱后，MCV≤100 fl仍是一个独立的不良变量（HR = 1.890，95%CI 1.007 - 3.548，P = 0.048）。在骨髓原始细胞<5%的亚组中，MCV≤100 fl的患者血红蛋白水平较高[90（42 - 153）g/L对78.5（28 - 146）g/L，P = 0.015]。在MCV≤100 fl组中，修订后的国际预后评分系统（IPSS - R）高危/极高危以及不良/极不良IPSS - R核型的比例更高（28.8%对10.8%，P = 0.003；24.7%对12.9%，P = 0.049）。MCV≤100 fl组的基因突变比MCV>100 fl组更多，尽管无统计学意义（0.988对0.769，P = 0.064）。突变的SF3B1在MCV≤100 fl组中出现频率较低（4.7%对15.4%，P = 0.018）。在骨髓原始细胞<5%的MDS患者中，校正临床和实验室变量以及突变图谱后，MCV≤100 fl是一个独立的不良变量。
