MDS-420 Low Risk Myelodysplastic Syndromes in Morocco

Abstract

Myelodysplastic syndromes (MDS) are a diverse group of clonal hematopoietic malignancies, characterized by ineffective hematopoiesis, progressive bone marrow failure, cytogenetic and molecular abnormalities, and variable risk of progression to acute myeloid leukemia (AML). Clinically, MDS patients often present with symptoms related to peripheral cytopenia (tiredness, pallor, infections, bruising, bleeding), although they may also be asymptomatic with abnormal blood counts found on routine evaluation. The most commonly used scores are the WHO Prognostic Scoring System (WPSS), International Prognostic Scoring System (IPSS), and more recently, the Revised International Prognostic Scoring System (RIPSS). In addition to the factors that make up these scores, other independent prognostic factors have been identified such as age, the Eastern Cooperative Oncology Group (ECOG) score, ferritin level, beta 2 microglobulin and lactic dehydrogenase (LDH). Our study includes all patients diagnosed with MDS between January 2004 and December 2018, over an age range of 5 months to 95 years, encompassing 272 patients. Data were collected from the patients' files. According to the prognostic score, we found 73 patients with a low risk, 165 patients with intermediate I risk; based on this score, 88% of the myelodysplasias in our series were of low risk. According to the IPSS-R, we found that 67 patients had a very low risk, 126 patients were at low risk, 36 patients were at intermediate risk. According to the IPSS and IPSS-R, low risk patients are children and adolescents, with a stable evolution. Abstinence from therapy was recommended as the treatment choice in 20% of patients with low-risk MDS. In our series, 74% of cases received symptomatic treatment including: 67% of cases were transfused with packed red blood cells, 22% were transfused with platelet units, 6% received iron chelators, 4% were treated with erythropoietin, 24% were treated with antibiotic therapy. Our results are consistent with published studies regarding the epidemiology, the clinic, and prognosis. Our study confirms the prognostic value of bone marrow karyotype and validates the WPSS IPSS and RIPSS scores in predicting overall survival of Moroccan patients with myelodysplastic syndromes.