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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

Immunophenotyping in Myelodysplastic Syndromes Can Add Prognostic Information to Well-Established and New Clinical Scores

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Autor(es):
Reis-Alves, Suiellen C. [1] ; Traina, Fabiola [1] ; Harada, Guilherme [2] ; Campos, Paula M. [2] ; Saad, Sara T. O. [2, 1] ; Metze, Konradin [2] ; Lorand-Metze, Irene [2, 1]
Número total de Autores: 7
Afiliação do(s) autor(es):
[1] Univ Estadual Campinas, Hematol & Hemotherapy Ctr, Sao Paulo - Brazil
[2] Univ Estadual Campinas, Fac Med, Sao Paulo - Brazil
Número total de Afiliações: 2
Tipo de documento: Artigo Científico
Fonte: PLoS One; v. 8, n. 12 DEC 6 2013.
Citações Web of Science: 15
Resumo

Background: myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic clonal disorders. So, prognostic variables are important to separate patients with a similar biology and clinical outcome. We compared the importance of risk stratification in primary MDS of IPSS and WPSS with the just described revision of IPSS (IPSS-R), and examined if variables obtained by bone marrow immunophenotyping could add prognostic information to any of the scores. Methods: In this prospective study of 101 cases of primary MDS we compared the relation of patients' overall survival with WHO types, IPSS, IPSS-R, WPSS and phenotypic abnormalities of hematopoietic precursors. We examined aberrancies in myelomonocytic precursors and CD34(+) cells. Patients were censored when receiving chemotherapy or BM transplantation. Survival analysis was made by Cox regressions and stability of the models was examined by bootstrap resampling. Results: median age: 64 years (15-93). WHO types: 2 cases of 5q-syndrome, 7 of RA, 64 of RCDM and 28 of RAEB. In the univariate Cox analysis, increasing risk category of all scores, degree of anemia, higher percentage of BM blasts, higher number of CD34(+) cells and their myeloid fractions besides increasing number of phenotypic abnormalities detected were significantly associated with a shorter survival. In the multivariate analysis comparing the three scores, IPSS-R was the only independent risk factor. Comparing WPSS with phenotypic variables (CD34(+)/CD13(+) cells, CD34(+)/CD13(-) cells and ``total alterations'') the score and ``CD34(+)/CD13(+) cells'' remained in the model. When IPSS was tested together with these phenotypic variables, only ``CD34(+)/CD13(+) cells'', and ``total alterations'' remained in the model. Testing IPSS-R with the phenotypic variables studied, only the score and ``CD34(+)/CD13(+) cells'' entered the model. Conclusions: Immunophenotypic analysis of myelomonocytic progenitors provides additional prognostic information to all clinical scores studied. IPSS-R improved risk stratification in MDS compared to the former scores. (AU)

Processo FAPESP: 04/08882-3 - Estudo da fisiologia do sistema imune nas neoplasias, autoimunidade e imunodeficiências por citometria de fluxo
Beneficiário:Sara Teresinha Olalla Saad
Linha de fomento: Auxílio à Pesquisa - Programa Equipamentos Multiusuários