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Izvestia Journal of the Union of Scientists - Varna. Medicine and Ecology Series

The role of MDS-CI in the prognostic assessment of patients with myelodysplastic syndrome

Merlin Efraim, Ilina Micheva


Myelodysplastic syndrome (MDS) is a heterogeneous group of acquired hematopoietic stem cell disorders characterized by ineffective hematopoiesis and a high risk of transformation into acute myeloid leukemia (AML). The MDS comorbidity index (MDS-CI) is designed to predict the impact of comorbidities on the outcome of the disease. Тhe aim of our analysis is to assess the prognostic value of MDS-CI within the WHO prognostic scoring system (WPSS) subgroups. We applied MDS-CI in 219 patients with MDS, diagnosed and treated in the Clinic of Hematology of St. Marina University Hospital, Varna, Bulgaria between May 2010 and May 2020. WPSS was used for prognostic stratification. Statistical analysis was performed using SPSS 20. We found that the mean age of patients with MDS was 70.7 ± 10.2 years (35–93 years). In patients with very low/low risk according to WPSS, we found significant difference in terms of survival between MDS-CI = 0 and MDS-CI > 2 (69.2 ± 43.0 vs. 38.3 ± 42.1 months, p < 0.001). Similar difference was found within the intermediate/very high risk groups (p < 0.001). MDS-CI adds prognostic value to the established WPSS. Combining both systems allows refining the prognostic assessment and survival of MDS patients.


myelodysplastic syndrome (MDS), MDS comorbidity index (MDS-CI), WHO prognostic scoring system (WPSS)

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