PROGNOSTIC IMPLICATIONS IN MYELODYSPLASTIC SYNDROMES - A REVIEW OF 62CASES

We retrospectively reviewed 62 MDS patients (15 RA, 3 RARS, 10 CMML, 2 0 RAEB, 14 RAEB-T) to clarify the current problems in their management . Median survival of RA and RARS patients was 67.9 months and signific antly longer than that of CMML, RAEB, or RAEB-T patients with median s urvivals of 16.1, 16.8, and 9.5 months, respectively. Karyotypic abnor malities were observed in 58% of the patients examined. Forty-two pati ents died, 16 (38%) of leukemic transformation and 21 (50%) of bone ma rrow failure. While most of the RAEB-T patients of all ages and all th e RAEB patients diagnosed below 60 years of age died of transformation , 70% of the older RAEB patients died of infection. Prognosis after tr ansformation was poor and 12 patients died within two months. These re sults indicate that management after transformation and treatment agai nst infection in RAEB patients with advanced age are crucial to improv e the prognosis in MDS.