Abstract
Background and Aims: In MDS the clinical course is primarily determined
by the extent of myeloid insufficiency and the risk of AML-evolution. Data
on the role of an impaired lymphopoiesis are emerging.
Methods: The database of the EU-MDS registry was screened for patients
with information about the absolute lymphocyte count (ALC) at diagnosis
and during follow-up. Lymphopenia was defined as an ALC <1.2 × 109
/μl.
Cases with an ALC ≥5.0 × 109
/μl were excluded.
Results: 2377 patients were identified (62% male, 38% female; median age
74 years, median follow-up 44.2 months), of whom 1469 were lymphopenic (970 at diagnosis, 499 during the observational period).
Lymphopenic patients had lower platelet and neutrophil counts (median
142 vs. 198 × 109
/μl and 1.9 vs. 2.7 × 109
/μl, p < 0.001 each) and were more
frequently transfusion-dependent (34 vs. 26%, p < 0.001). Between the
IPSS-R-cytogenetic risk categories, no difference was noted with regard to
the proportion of lymphopenic patients. Age-adjusted median survival was
shorter for patients with an ALC <1.2 × 109
/μl (101.3 versus 54.0 mo,
p < 0.001). No difference was noted for IPSS-R-very-high-, high- and
intermediate-risk patients (n = 25, 85 and 347, respectively). For very-low
(n = 1240) and low-risk patients (n = 1425), lymphopenia was associated
with a shorter survival (91.5 vs. 134.4 mo, p < 0.001, and 52.8 versus 79
month, p = 0.001, respectively).
Conclusions: Our data confirm the relatively high prevalence of lymphopenia in MDS patients. For IPSS-R-very low and low-risk patients,
lymphopenia provides additional prognostic information. Further research
will focus on the influence of the mutational status as determined by NGS
on the ALC.
by the extent of myeloid insufficiency and the risk of AML-evolution. Data
on the role of an impaired lymphopoiesis are emerging.
Methods: The database of the EU-MDS registry was screened for patients
with information about the absolute lymphocyte count (ALC) at diagnosis
and during follow-up. Lymphopenia was defined as an ALC <1.2 × 109
/μl.
Cases with an ALC ≥5.0 × 109
/μl were excluded.
Results: 2377 patients were identified (62% male, 38% female; median age
74 years, median follow-up 44.2 months), of whom 1469 were lymphopenic (970 at diagnosis, 499 during the observational period).
Lymphopenic patients had lower platelet and neutrophil counts (median
142 vs. 198 × 109
/μl and 1.9 vs. 2.7 × 109
/μl, p < 0.001 each) and were more
frequently transfusion-dependent (34 vs. 26%, p < 0.001). Between the
IPSS-R-cytogenetic risk categories, no difference was noted with regard to
the proportion of lymphopenic patients. Age-adjusted median survival was
shorter for patients with an ALC <1.2 × 109
/μl (101.3 versus 54.0 mo,
p < 0.001). No difference was noted for IPSS-R-very-high-, high- and
intermediate-risk patients (n = 25, 85 and 347, respectively). For very-low
(n = 1240) and low-risk patients (n = 1425), lymphopenia was associated
with a shorter survival (91.5 vs. 134.4 mo, p < 0.001, and 52.8 versus 79
month, p = 0.001, respectively).
Conclusions: Our data confirm the relatively high prevalence of lymphopenia in MDS patients. For IPSS-R-very low and low-risk patients,
lymphopenia provides additional prognostic information. Further research
will focus on the influence of the mutational status as determined by NGS
on the ALC.
| Original language | English |
|---|---|
| DOIs | |
| Publication status | Published - 24 Sept 2021 |
| Event | Advancing Research & Patient Care The 16th International Congress on Myelodysplastic Syndromes: Virtual congress - Duration: 23 Sept 2021 → 26 Sept 2021 |
Other
| Other | Advancing Research & Patient Care The 16th International Congress on Myelodysplastic Syndromes |
|---|---|
| Period | 23/09/21 → 26/09/21 |