Can bone marrow cellularity help in predicting prognosis in myelodysplastic syndromes?

Uri Greenbaum, Erel Joffe, Kalman Filanovsky, Howard S. Oster, Ilya Kirgner, Itai Levi, Pia Raanani, Irit Avivi, Esther Manor, Gili Man-El, Moshe Mittelman

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objectives: To ascertain the relevance of bone marrow cellularity (BMC) to the interpretation of blast percentage (blast%) in MDS prognostication. Methods: We compared survival prediction based on blast% adjusted to different levels of cellularity, compared to the survival based on the original IPSS-R blast% grouping. Results: We analyzed 355 consecutive MDS patients. Cellularity, in and of itself or its interaction with blast%, was not associated with overall survival (OS). In a small subset of patients with a hypercellular marrow (15%; n = 26), dismal prognosis was observed at lower levels of blast%. For these cases OS was similar to higher IPSS-R blast groups. For example, within the Intermediate group (blast% 5%-10%), those with a hypercellular marrow and >6% blasts had an OS of 10 m similar to 16 m in the High (blast% 10%-19%) blast group. These changes did not translate into a significant improvement in overall prognostic power of a cellularity-adjusted IPSS-R (C index 0.71 vs. 0.70). Conclusion: Adjusting blast% to cellularity did not improve prognostication. However, within IPSS-R-defined blast groups, a small subset of patients with relatively higher blast% and hypercellularity may have a worse prognosis than expected.

Original languageEnglish
Pages (from-to)502-507
Number of pages6
JournalEuropean Journal of Haematology
Volume101
Issue number4
DOIs
StatePublished - 1 Oct 2018

Keywords

  • MDS
  • bone marrow cellularity
  • bone marrow failure
  • myelodysplastic syndromes
  • prediction modeling in cancer

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