Publicaciones científicas
Prognostic impact of micromegakaryocytes in primary myelodysplastic syndromes
Sílvia Saumell 1 , Miranda Fernández-Serrano 2 3 , Alba Mesa 1 , Félix López-Cadenas 4 , Leonor Arenillas 5 , Ana Alfonso 6 , Maria Julia Montoro 1 , Antonieta Molero 1 , Pilar Leoz 4 , Victoria Riego 6 , Laura Gallur 1 , Olga Salamero 1 , Mayda Navarrete 1 , Bárbara Tazón-Vega 1 , Margarita Ortega 1 , Òscar Reig 7 , Gaël Roué 1 3 , Xavier Calvo 5 , Felipe Prosper 6 , María Díez-Campelo 4 , David Valcárcel 1
Abstract
Micromegakaryocytes (microMKs) are considered a myelodysplastic feature of myeloid neoplasms in adults, with an adverse prognosis connotation. However, this notion in MDS has not been well proved.
In our cohort of 287 MDS, patients with microMKs showed lower overall survival (OS) (HR, 2.12; 95% CI, 1.47-3.06; p = 0.000036) and higher risk of acute myeloid leukemia (AML) evolution (HR, 4.8; 95% CI, 2.9-11.01; p = 0.00021). Results were validated with an independent cohort.
In multivariate analysis, the presence of microMKs maintained its independent association with OS (HR, 1.54, 95% CI, 1.13-2.1, p = 0.0059) and AML transformation (HR, 2.28, 95% CI, 1.2-4.4, p = 0.014). Moreover, by adding 1 point to the IPSS-R score in patients with microMKs, we improved the IPSS-R accuracy. Interestingly, adding that 1-point, 29% of intermediate IPSS-R risk group patients were upgraded to the high-risk group.
In summary, we confirmed that the presence of microMKs implies worse outcomes in MDS and suggested a modification improving IPSS-R.
CITA DEL ARTÍCULO Leuk Lymphoma. 2022 May;63(5):1227-1235.
doi: 10.1080/10428194.2021.2018581. Epub 2021 Dec 31.
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