Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study Group

• Published in: Annals of oncology Vol. 21; no. 1; pp. 114 - 119
• Main Authors: Sperr, W. R., Wimazal, F., Kundi, M., Baumgartner, C., Nösslinger, T., Makrai, A., Stauder, R., Krieger, O., Pfeilstöcker, M., Valent, P.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.01.2010
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic agents; Austria; Biological and medical sciences; Comorbidity; Disease-Free Survival; Female; Hematologic and hematopoietic diseases; Humans; Kaplan-Meier Estimate; Leukemia, Myeloid, Acute - epidemiology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; MDS; Medical sciences; Middle Aged; Myelodysplastic Syndromes - epidemiology; Pharmacology. Drug treatments; Precancerous Conditions - epidemiology; Prognosis; prognostication; Retrospective Studies; survival; Young Adult; Austria; comorbidity; MDS; prognostication; survival; Human; Evaluation; Prognosis; Patient; Malignant hemopathy; Survival; Myelodysplastic syndrome; Concomitant disease; Comparative study; Cancer
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdp258

Background: The evaluation of comorbidity is of increasing importance in patients with hematologic disorders. Patients and methods: In the present study, the influence of comorbidity on survival and acute myeloid leukemia (AML) evolution was analyzed retrospectively in 419 patients with de novo myelodysplastic syndromes (MDS) (observation period: 1985–2007). The median age was 71 years (range 24–91 years). Two different scoring systems, the hematopoietic stem-cell transplantation-specific comorbidity index (HCT-CI) and the Charlson comorbidity index (CCI) were applied. Results: The HCT-CI was found to be a significant prognostic factor for overall survival (OS, P < 0.05) as well as event-free survival (EFS, P < 0.05) in our patients, whereas the CCI was of prognostic significance for OS (P < 0.05), but not for EFS. For AML-free survival, neither the HCT-CI nor the CCI were of predictive value. A multivariate analysis including age, lactate dehydrogenase, ferritin, karyotype, number of cytopenias, French–American–British groups, and comorbidity was applied. Comorbidity was found to be an independent prognostic factor in patients with low- or int-1-risk MDS (P < 0.05) regarding OS and EFS. Conclusions: Together, our data show that comorbidity is an important risk factor for OS and EFS in patients with MDS.