Kinetics of Pre-Myelodysplastic Syndromes Blood Values Correlate with Disease Risk and Survival

We reviewed pre-diagnosis clinical data of 420 patients with pathologically confirmed myelodysplastic syndromes myelodysplastic syndromes: (my-eh-lo-diss-PLASS-tik SIN-dromez) A group of disorders where the bone marrow does not work well, and the bone marrow cells fail to make enough healthy blood cells. Myelo refers to the bone marrow. Dysplastic means abnormal growth or development. People with MDS have low blood cell count for at… (MDS) presenting with anemia anemia: (uh-NEE-mee-uh) A condition in which there is a shortage of red blood cells in the bloodstream. This causes a low red blood cell count. Symptoms of anemia are fatigue and tiredness. . In 232 patients with yearly pre-diagnosis blood counts (CBC) we also analyzed CBC kinetics in respects to a standardized timepoint in which all patients had similar levels of hemoglobin hemoglobin: A protein in the red blood cells. Hemoglobin picks up oxygen in the lungs and brings it to cells in all parts of the body. (Hgb). At the standardized timepoint (last documented 12 > Hgb≥11 g/dL), occurring months-years before diagnosis, median CBC values were Hgb 11.4 g/dL, neutrophils (ANC) 2.7x103 (k)/mcl, platelets (PLT) 181 k/mcl. Gradual changes in CBC could be observed years prior to this timepoint, for the most part while within normal/near-normal limits (WNL). During this time, most patients had a coexisting alternative etiology etiology: The cause or origin of a disease. for anemia. Patients with high-risk cytogenetic/blast features had a rapid and steeper decrease in counts in the last year before developing a concerning anemia (decrease in: Hgb 0.75 g/dL vs 0.55 g/dL; PLT 29.5 vs 4.5 k/mcl; ANC 0.86 vs 0.4 k/mcl, P = 0.03). Low-risk patients had a high rate of longstanding mild anemia (31% vs 16%, P = 0.05). Rate of development of cytopenia cytopenia: (sie-tuh-PEE-nee-uh) A shortage of one or more blood cell types. Also called a low blood count. and number of involved hematopoietic lines were prognostic. In 65% of patients, with near normal CBC at the standardized timepoint, but in whom there was a decrease in multiple hematopoietic lines over the preceding year, the 5-year overall survival (5yOS) was 53% compared to 71% in patients with isolated slowly progressing anemia (20% of patients). In 15% of patients with mild cytopenia developing after both a rapid decrease and multiple involved lines, prognosis was dismal (5yOS 34%). In conclusion, kinetics of pre-MDS CBC values correlate with disease risk and survival.