伴发糖尿病的骨髓增生异常综合征的临床特征、基因突变和转归。
The clinical characteristics, gene mutations and outcomes of myelodysplastic syndromes with diabetes mellitus.
机构信息
Department of Hematology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Department of Hematology, Shanghai Jiao Eighth People's Hospital, Shanghai, 200233, China.
出版信息
J Cancer Res Clin Oncol. 2024 Feb 2;150(2):71. doi: 10.1007/s00432-023-05591-4.
PURPOSE
Diabetes mellitus (DM) is the second most common comorbidity in myelodysplastic syndromes (MDS). The purpose of the study was to investigate the clinical characteristics of MDS patients with DM.
METHODS
A retrospective analysis was performed on the clinical data of 890 MDS patients with or without DM. Clinical data, including genetic changes, overall survival (OS), leukemia-free survival (LFS) and infection, were analyzed.
RESULTS
Among 890 patients, 184 (20.7%) had DM. TET2 and SF3B1 mutations occurred more frequently in the DM group than those in the non-DM group (p = 0.0092 and p = 0.0004, respectively). Besides, DM was an independent risk factor for infection (HR 2.135 CI 1.451-3.110, p = 0.000) in MDS. Compared to non-DM patients, MDS patients with DM had poor OS and LFS (p = 0.0002 and p = 0.0017, respectively), especially in the lower-risk group. While in multivariate analysis, DM did not retain its prognostic significance and the prognostic significance of infection was maintained (HR 2.488 CI 1.749-3.538, p = 0.000).
CONCLUSIONS
MDS patients with DM have an inferior prognosis which may due to higher infection incidence, with TET2 and SF3B1 mutations being more frequent in those cases.
目的
糖尿病（DM）是骨髓增生异常综合征（MDS）的第二大常见合并症。本研究旨在探讨合并 DM 的 MDS 患者的临床特征。
方法
对 890 例有或无 DM 的 MDS 患者的临床资料进行回顾性分析。分析临床数据，包括遗传改变、总生存期（OS）、无白血病生存期（LFS）和感染。
结果
在 890 例患者中，184 例（20.7%）患有 DM。DM 组的 TET2 和 SF3B1 突变发生率高于非 DM 组（p=0.0092 和 p=0.0004）。此外，DM 是 MDS 患者感染的独立危险因素（HR 2.135，CI 1.451-3.110，p=0.000）。与非 DM 患者相比，合并 DM 的 MDS 患者的 OS 和 LFS 较差（p=0.0002 和 p=0.0017），尤其是在低危组。而在多变量分析中，DM 并未保留其预后意义，感染的预后意义仍然存在（HR 2.488，CI 1.749-3.538，p=0.000）。
结论
合并 DM 的 MDS 患者预后较差，可能是由于感染发生率较高，且此类患者 TET2 和 SF3B1 突变更为常见。
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