Association Study Between Platelet Number At Initial Diagnosis And Clinical Characteristics And Prognosis Of Myelodysplastic Syndrome

Objective:To explore the association of the platelet number at diagnosis and the clinical features and prognosis of newly diagnosed myelodysplastic syndrome.Methods:We collected 137 newly diagnosed MDS patients in our hospital from January 1,2014,to October 31,2020.The patient’s case data and telephone survey records were collected in retrospective analysis.The clinical data of the patients were processed statistically.MDS patients were divided into three groups according to whether the platelets were reduced and the degree of reduction at the time of diagnosis.The prognosis was evaluated according to IPSS and IPSS-R,and statistical analysis of data between different groups was performed.Results:Among the 137 newly diagnosed MDS patients included in this study,30 cases(21.9%)were in the group without platelet reduction(PLT≥100×10~9/L),and27 cases were in the group with mild platelet reduction PLT(50～99)×10~9/L(19.7%),80 cases(58.4%)in the severely reduced platelet group(PLT<50×10~9/L).In the three groups of patients,the lower the platelet count,the proportion of patients aged>55years(P=0.003),the proportion of patients with clinical symptoms(P=0.006),the proportion of patients with gene mutations(P<0.001),the poor prognostic karyotype of IPSS(P=0.027)and IPSS-R(P=0.045)were higher,with statistical significance.The lower the platelet count for 65 patients with MDS-SLD and MDS-MLD,the higher the proportion with the absolute value of neutrophils<1.2×10~9/L(P=0.01).Platelet count was negatively correlated with clinical symptoms(P=0.018,r=-0.201),platelet count was positively correlated with age and absolute value of neutrophils(P values were 0.011,<0.001,r were 0.216,0.498,respectively).In the three groups of patients with PLT≥100×10~9/L,PLT(50～99)×10~9/L,and PLT<50×10~9/L,the median survival time was 36,30,and 30 months,respectively.The survival time of the three groups was not a significant statistical difference(P=0.557).Age>55 years[HR=3.098(95% CI 1.109 to 8.659),P=0.031] was an independent poor prognostic factor for patients.Conclusion:The severity of thrombocytopenia at diagnosis relates to the higher proportion of overt clinical symptoms,gene mutations,and karyotypes.In newly diagnosed MDS-SLD and MDS-MLD patients,the decrease of platelet counts parallel to neutropenia.However,it was observed in this study that the severity of thrombocytopenia at diagnosis is not significantly correlated with the overall survival time of MDS patients,Age>55 years was an independent poor prognostic factor for patients.