MDS-407 High Risk Myelodysplastic Syndrome

Abstract

Myelodysplastic syndromes are characterized by a frequent evolution into acute leukemia. Research has made it possible to better understand their physiopathology, and have made advances in classification, prognosis and treatment. The main objective of our study is to determine the incidence of high-risk myelodysplastic syndromes in the general population in Morocco. Patients diagnosed with MDS classified as high risk by the IPSS score between January 2004 and December 2018. We data on collected 34 patients with high-risk MDS, the average frequency of cases per year was 2.5 cases, the median age is 59.5 years, the sex ratio is 0.74. 1% of patients were genetically predisposed, 16% of patients with occupational and environmental exposure. Clinically the main symptoms of the disease were anemia, hemorrhage, and infectious syndrome. The median time between the onset of symptoms and the date of diagnosis is 3 months. The infectious sites concerned were the ENT site, the urinary site, the digestive site, and the pulmonary site. According to the IPSS-R: According to the IPSS, patients at high risk are young adults (n=9), elderly subjects (n=4), and very elderly subjects (n=4). Patients with high or very high risk IPSS-R have median survival times of 4.61 and 4.4 months, respectively. 74% of cases received symptomatic treatment, 6.5% of cases received specific treatment with azacitidine, and 3% of cases received chemotherapy based on cytarabine. The disease was stable in 70.5% (n=24) of the cases, whereas 29.5% (n=10) of the cases transformed into acute leukemia. The median time between the date of diagnosis and the date of transformation into AML is 3 months, with extremes ranging from 32 to 270 days. The number of deaths is 32% (n=11); median survival is 4 months. Our results agree with the studies published in the literature with regard to epidemiology, incidence, clinic, prognosis, and symptomatic treatment, but there are some discrepancies in terms of specific treatment and global survival. Myelodysplastic syndromes remain a serious problem that threatens the health of patients. The main complication detected in our series was transformation into acute leukemia.