Prognostic evaluation of comorbidities in patients with myelodysplastic syndrome

Objective To discuss the impact of comorbidities on the outcomes of patients with MDS. Methods The clinical characteristics of 676 MDS patients with detailed comorbidities evaluations was analyzed retrospectively. Results There were 395/676 cases (58.4%) with comorbidities (group 1), 281/676 cases(41.6%) without (group 2). Significant differences were seen in the distribution of age (≥60 y), bone marrow blasts, abnormal karyotype, WHO 2008 subtypes and IPSS-R risk cohorts (P 0.05). Independent prognostic significance of comorbidities was seen in both uni-variate and multi-variate analyses (P<0.001). According to MDS-specific comorbidity index (MDS-CI), the median survival were 32(1-153) months, 19(2-85) months and 13(1-37) months in the low-risk, intermediate-risk and high-risk cohorts respectively, while 96(1-166) months in cohorts without any comorbidities, of which significant differences were seen (P<0.001). The MDS- CI allowed further stratification in the IPSS- R low- risk, intermediate- risk and high- risk cohorts (P<0.001). Conclusion Comorbidities provides prognostic stratification independently of IPSS-R for MDS patients. Key words: Myelodysplastic syndromes; Comorbidity; Prognosis