In the high-risk subgroup the causes of death were: evolution to AML 18, disease progression 3, infection 13 and bleeding 5. Non-MDS-related causes were: second malignancy 1, congestive heart failure 1, and accidental 1 Figure 1. In conclusion, the most frequent cause of death in both low-risk and high-risk subgroups was related to the MDS evolution to AML. Non-MDS-related deaths were more common in low-risk subgroup, being the most frequent causes heart failures and second malignancies. Causes of death in MDS should be taking into consideration when analyzing response and survival in clinical trials, particularly when applied to patients belonging to low-risk subgroups.
View large Download slide. Add comment Close comment form modal. Submit a comment. Comment title. You have entered an invalid code. Thank you all for joining us today. Raza, I wanted to ask you just to start with the presentation of MDS and the common disease characteristics when you first meet somebody. For low-risk myelodysplastic syndromes, a number of patients are actually picked up serendipitously because they present for an annual physical exam to their primary care physician, and, there, a CBC would reveal that one of their blood counts is low, and this leads to further workup.
So, typically, at presentation, they have weakness, fatigue, bruising, and occasionally, signs of infection. James M. They go through a cardiac workup or something else for comorbid diseases.
Do you think the comorbidities play into this, or the age or functional status of the patients when they come in to see you? Azra Raza, MD: Definitely, because it is a disease of the elderly, so I think you bring up a good point that many of these patients, because of their comorbidities, get worked up for other things. Of course, once a CBC is done and one of the counts at least is found to be low, that always raises the level of suspicion about a primary bone marrow disorder.
There are some limitations to remember: The numbers below are based on patients diagnosed with a myelodysplastic syndrome MDS some time ago. Improvements in treatment since these numbers were gathered may result in a better outlook for people now being diagnosed with MDS. These numbers are based on prognostic scores that take into account certain factors, such as the type of MDS, the results of certain blood tests, and whether the abnormal cells have certain chromosome changes.
This prognostic scoring system tells your doctor how severe your disease is and how likely it is that your MDS might become acute myeloid leukemia AML. It also gives your doctor a general idea about how long you might live. With current treatments, patients with lower-risk types of some MDS can live for 5 years or even longer. Most patients with AML need treatment soon after diagnosis because the disease often progresses fast.
The initial goal is to put the patient into remission. The long-term goal is to cure the disease, although this is not always possible.
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