الفهرس 
Initial EvaluationOnly 14 pages are availabe for public view
 |  | from | 129 |  |  |
| | | from | 129 | | |
Abstract
M
yelodysplastic syndromes (MDS) are clonal hematopoietic stem cell (HSC) disorders predominating in the elderly, characterized by ineffective hematopoiesis leading to blood cytopaenias and by progression to acute myeloid leukemia (AML) in one-third of cases (Tefferi et al., 2009).
Diagnosis of MDS is based on the blood and marrow examination, showing blood cytopaenias, hypercellular marrow with dysplasia, with or without an excess of immature marrow cells (blasts) (Vardiman et al., 2009).
Prognosis is largely based on the marrow blast percentage, number and extent of cytopaenias and cytogenetic abnormalities, which are grouped in a recently Revised International Prognostic Scoring system (IPSS/IPSS-R) (Greenberg et al., 2012).
This study was conducted to assess the impact of combining myleodysplastic syndrome scoring system with comorbidity index on prognosis.
This study was a cross sectional study that 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.
Our study was conducted on 41 patients with MDS,it included 19 male (46.3%) and 22 female(53.7%),whose age ranged from 25 to 75years old with median age 48 years old and their disease duration ranged from 5 months to 56 month. The commonest subtype was RCMD (41.46%) and RA (34.14%).
All patients were confirmed as MDS and they were classified according to the WHO classification system by: initial scoring systems, in the form of IPSS and IPSS-R scoring system. Associated comorbidities, treatment modality, and outcome of these patients were recorded for every visit within 9 months and they were subjected to history taking, clinical examination and laboratory investigations.
Our study shows that 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 & 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 & very high IPSS-R groups.
In our study; treatment had no impact on prognosis because all of the patients received supportive treatment only, none received definitive treatment as hypomethylating agents.