Signiifcance Of Combining Laboratory Parameters And Morphology Analysis For Prognosis Of Patients With MDS

Objective：To study the prognostic value of basal laboratory parameters combiningmorphology analysis of patients with MDS. Method：152patients with MDS wasretrospective observed. The features of clinical, laboratory examination, morphologiccharacteristics was analysed of patients. At the same time, selected100cases of healthyphysical examination， detected basal laboratory parameters of them as compare.Selecting possible prognostic factors according with IPSS system in patients withMDS.Using univariate analysis and multivariate analysis to investigate the relationship ofOS and factors above, then applicating the factors which have selected for OS toreevaluate the prognosis of152patients. Results: Out of the152cases,68cases (44.7%)died,median overall survival time was12(5-36) months. Patients with MDS hassignificantly higher level of MCV, LDH, β2-MG, SF and VitB12than normal controlgroup(P<0.05). LDH,β2-MG,SF level in four groups divided according to the IPSS aresignificant difference (P<0.05). Bone marrow morphology abnormality that tri-linemyelodysplasia, erythrocytic megaloblast， multi-nuclear erythrocytes, nucleoplasmdevelopment imbalance, pseudo-pelger nucleus, small megakaryocytes, and mono-roundnuclear distributed significant differently in relative high risk and low-risk groupsaccording to the IPSS(P<0.05). Univariate analysis indicated that LDH,β2-MG,SF, tri-linemyelodysplasia, multi-nuclear erythrocytes, pseudo-pelger nucleus, small megakaryocytes,and mono-round nuclear were all OS poor prognostic factors. Multivariate analysis foundthat SF, pseudo-pelger nucleus and small megakaryocytes were OS independent poorprognostic factors. combined prognostic factors above to score all thepatients(independent poor prognostic factors scoring1and other factors scoring0.5),thepoints from the new mode is positive correlation with IPSS group（r=0.626，P＜0.001).Divided the patients into three groups (0~1.5points,2~3.5points,≥4points)according to the new mode，OS of every group were significant difference (2=101.870, P<0.001). Conclusion: Combinedly use of LDH, β2-MG, SF laboratoryparameters and marrow morphology analysis like tri-line myelodysplasia, multi-nuclear erythrocytes, pseudo-pelger nucleus, small megakaryocytes, and mono-round nuclearmyelodysplasia to judge the prognosis of patients with MDS having a significant clinicalvalue, and which might useful to add the IPSS prognostic system of the MDS.