Influence of platelet count at diagnosis and during the course of disease on prognosis in MDS patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-07-29

AUTHORS

Judith Strapatsas, Elena Calina Barbulescu, Michael Lauseker, Jennifer Kaivers, Barbara Hildebrandt, Kathrin Nachtkamp, Corinna Strupp, Martina Rudelius, Rainer Haas, Ulrich Germing

ABSTRACT

Thrombocytopenia at diagnosis and platelet drop within the first 6 months have an adverse effect on prognosis of MDS patients. We therefore were interested in the association and impact on prognosis of morphologic findings of megakaryocytes and platelets with platelet count at diagnosis, bleeding complications, and the drop of platelets during the course of disease. This retrospective analysis was based on 334 MDS patients from the Duesseldorf MDS registry that were followed up for blood counts, bleeding, transfusion dependency, and AML evolution and correlated with morphology of the megakaryocytes and platelets. Thrombocytopenia was found more frequently in higher risk MDS and was associated with hypocellularity of the megakaryocytes in the bone marrow. Signs of bleeding were present at diagnosis in 14% and occurred during the disease in 48% of all MDS patients. Death due to bleeding was ranked third behind infections and AML. A decrement of platelets during the first 6 months was associated with an inferior overall survival of 21 vs. 49 months and with a higher cumulative 2-year AML rate of 22.2% vs. 8.3% (p = 0.001). In a multivariate analysis, besides bone marrow blasts and karyotype, decreasing platelets were also associated with an inferior outcome. Signs of bleeding are present in a relevant number of MDS patients and account for significant morbidity and mortality in MDS. We could demonstrate the prognostic importance of decreasing platelets during the course of disease in all MDS patients, identifying patients at higher risk for death or AML progression. More... »

PAGES

2575-2584

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00277-021-04608-7

DOI

http://dx.doi.org/10.1007/s00277-021-04608-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1140006739

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34324021


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