Value Of Clinical Features,Cytogenetics And Prognosis Of60 Patients With Myelodysplastic Syndrome

Objective In this study,the clinical difference of patients diagnosed as MDS are statistically analyzed,including the patient’s first symptoms,age of onset,gender,disease type,peripheral blood cell count,lactate dehydrogenase,average blood cell volume,bone marrow cell chromosomal genetic characteristics and risk level.And then we analyze the survival of patients and explore the prognosis of MDS patients with different clinical characteristics.Methods Sixty patients with MDS who were newly diagnosed in the Department of Hematology of our hospital between January 1,2009 and December 31,2018 were collected.Clinical data of MDS patients were retrospectively analyzed,including general clinical characteristics,chromosome karyotypes,treatment regimens,and overall survival.Results The age of 60 patients diagnosed as MDS ranged from 17 to 78 years old,and the average age of onset was 58 years old.60 patients are classified by WHO(2008),including 4 RCUD patients,3 RARS patients,29 RCMD patients,11 RAEB-1 patients,and 13 RAEB-2 patients.26 patients are(43.3%)with abnormal karyotypes,14 male patients,accounting for 53.8% of abnormal karyotypes,accounting for 23.3% of all karyotypes,12 female cases,accounting for 46.2% of abnormal karyotypes,accounting for 20.0% of all karyotypes.There are 10 cases with complex karyotypes.The relative clinical patients in the lower-risk group and the higher-risk group according to IPSS are analyzed : the patient’s age of onset,neutrophil count and LDH activity are significantly different between the two groups.Patients with a higher proportion of bone marrow blasts or more severe anemia may be accompanied by increased LDH activity.We group the patients according to whether the chromosome karyotype is abnormal,and analyze the differences in gender and disease classification of the patients.It is found that the data of the three groups are not statistically significant,while the differences of the three prognostic scoring systems such as IPSS,IPSS-R and WPSS are statistically significant.It is found that patients with normal chromosome karyotypes are mostly concentrated in the low-risk group,while patients with abnormal chromosome karyotypes are mostly concentrated in the relatively high-risk group.The difference between groups is statistically significant,and the risk stratification in the abnormal chromosome karyotypes group is often higher.Patients with different clinical characteristics also had different survival times,ranging from 2 to 115 months.Patients in the lower risk group survived longer.We find that all-trans retinoic acid has better efficacy and prolong survival in patients with MDS in the lower risk group.Conclusion The clinical characteristics and cytogenetics of MDS patients are obviously heterogeneous.Patients with abnormal chromosome karyotypes tend to have higher risk stratification,and the more complex the chromosome karyotypes are,the worse the overall survival is.Increased LDH activity is associated with the increase of bone marrow blasts and the aggravation of anemia,and its level is related to the prognosis of MDS.High LDH level usually means poor prognosis.All trans retinoic acid has a good efficacy in the low-risk group of MDS,which can improve the patients’ survival.