MYELODYSPLASTIC SYNDROME SCORING SYSTEM WHEN COMBINED WITH COMORBIDITY INDEX, WILL PROGNOSIS DIFFER?

Abstract

Background: Comorbidities significantly affect the prognosis and outcomes of patients with MDS who have been classified by the International Prognostic Scoring System (IPSS) score. The aim of this study: To assess the impact of combining myleodysplastic syndrome scoring system with comorbidity index on prognosis. Patients and Methods: This study was a cross sectional study which included 41 patients with MDS, regularly attending hematology Clinic at Internal Medicine Hospital, Ain Shams University & Nasser Institute during the period between April 1st 2015 till December 31st 2015. They were 19 males and 22 females, their ages ranged from 25 - 75 years old and their survival duration ranged from 5 to 56 months and mean duration of follow-up of living patients was 9 months. All patients were confirmed to have MDS and classified according to the WHO classification system. Initial scoring systems in the form of IPSS and IPSS-R scoring system were applied. Associated comorbidities, individual comorbid ailments and information defining the severity of comorbid health was extracted using the Adult Comorbidity Evaluation 27 (ACE-27). Result: Comorbidity had an unfavorable effect on life expectancy of patients with myelodysplastic syndromes (MDS). The ACE-27 comorbidity score significantly impacted the median survival of patients with intermediate-1 IPSS group and with intermediate IPSS-R groups; but did not significantly impact the median survival neither in low, intermediate-2 group & high IPSS groups nor the low, very low, high and very high IPSS-R groups. Conclusion: Our study shows that comorbidity has a significant impact on the survival of patients with MDS after adjusting with IPSS and IPSS-R scoring systems and a comprehensive assessment of the severity of comorbidities with ACE-27 score.