| Objective:To inspect the correlation between different clinical features,prognosis and survival in patients with myelodysplastic syndrome(MDS).Materials and methods:The clinical data of 62 patients diagnosed with MDS in the First Hospital of Nanchang from January 1,2014 to December 31,2021 were collected including gender,age,clinical manifestations,total white blood cell(WBC),neutrophils absolute count(ANC),hemoglobin(HB),platelet count(PLT),lactate dehydrogenase(LDH),bone marrow smear,chromosome karyotype analysis,gene mutation,treatment scheme and survival time.The data and the graph were analyzed with spss26.0software,and the statistical difference is expressed in p<0.05.Results:1.These 62 newly treated MDS patients(38 male patients and 24 female patients),with a male to female ratio of 1.58:1.The median age of onset was 70(19-89)years.2.The median of the PLT and LDH in higher risk(HR)-MDS were 32×109/L and 363.2U/L,in lower risk(LR)-MDS were 64×109/L and 142.3U/L(p<0.05).LDH was positively correlated with IPSS-R stratification and the numbers of clinical symptom(r=0.703,p<0.001;r=0.437,p<0.001).HR-MDS associated with more clinical symptoms(r=0.511,p<0.001).3.The median of the ANC and LDH in the MDS-EB were 0.71×10~9/L and335.70U/L,but the non MDS-EB were 1.52×10~9/L and 194.70 U/L(p<0.05).4.In total 62 MDS patients,the chromosome abnormality rate of the 62 patients was 50%(31/62),of which the chromosome 5 abnormality rate was 41.93%(13/31),and the chromosome 8 abnormality rate was 35.48%(11/31).The median overall survival(OS)of the abnormal chromosome 5 group was 35months,which significantly inferior in the normal karyotype(NK)group(41 months)(p=0.021).The diferences of the median OS between the without abnormal chromosome 5 group(45months)and the NK group was not significant(p=0.811),but there was a significant difference between the abnormal chromosome 5 group and the without group(p=0.043).There was a significant difference between the NK group(66years)and the chromosomal abnormality group(75years)in the median age of onset(p=0.028).Also,there was a significant difference between the NK group(217.0U/L)and the chromosomal abnormality group(363.0U/L)in LDH(p=<0.001).Age and LDH were positively correlated with chromosomal abnormalities(r=0.310,p=0.027;r=0.448,p<0.001).5.The gene mutation positive rate of 62 patients was 56.45%,which the mutation frequency of ASXL1,TP53,U2AF1,TET2,SF3B1,NRAS and SRSF2 was higher than 5%.Except for ASXL1 mutation,which is positive tended to be in the HR-MDS(χ~2=5.094,p=0.031),the rest mutations are not related to IPSS-R,and there was no significant difference in the OS between the above gene mutations.There was a significant difference in median WBC between the genetic mutation group(2.39×10~9/L)and the without gene mutation group(3.45×10~9/L)(p=0.008),and also in the median LDH between the genetic mutation group(363.2U/L)and the non gene mutation group(193.7U/L)(p<0.001).Genetic mutations was inversely correlated with WBC(r=-0.340,p=0.007),but positively correlated with LDH(r=0.488,p<0.001).6.The chromosomal abnormalities,polygenic mutations,and the high score of IPSS-R were Influencing factors of OS(p=0.032,p=0.009,p=0.011),the polygenic mutations was an independent risk factor of OS(HR=1.883,95%CI:0.872-4.066,P=0.007).Conclusion:1.LDH in the HR-MDS group and the MDS-EB group was higher than that in the LR-MDS group and the not-MDS-EB group,the amount of the clinical symptom was more in the HR-MDS.2.Abnormalities of chromosome 5 affecting the patient’s OS;age and LDH were higher in the chromosomal abnormalities group than that in the NK group.3.Mutation positive rate of ASXL1,TP53,U2AF1,TET2,SF3B1,NRAS,SRSF2 was higher among all mutations in MDS,ASXL1 mutation had high IPSS-R stratification;WBC were lower in groups with genetic mutations;LDH was higher in groups with genetic mutations.4.The chromosomal abnormalities,polygenic mutations,and the high score of IPSS-R were Influencing factors of OS.The polygenic mutations was an independent risk factor of OS. |
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