C. Aul et al., PROGNOSTIC-SIGNIFICANCE OF SERUM THYMIDIN E KINASE IN THE MYELODYSPLASTIC SYNDROME, Deutsche Medizinische Wochenschrift, 121(37), 1996, pp. 1113-1118
Objective: To assess the prognostic value of serum thymidine kinase (s
TK) activity in patients with the myelodysplastic syndrome (MDS). Pati
ents and methods: The study included 255 patients (144 men, 111 women,
median age 67 [14-97] years) in whom primary MDS had been diagnosed b
etween 1986 and 1995 (refractory anaemia [RA]: n = 40; RA with ring si
deroblasts: n = 38; RA with increased blasts: n = 76; RA with increase
d blasts in transformation: n = 45; chronic myelomonocytic leukaemia:
n = 56). 69 healthy persons (28 men, 41 women, median age 33 [24-62] y
ears) served as controls. The normal laboratory range for sTK was betw
een 0.9 and 4.9 U/mu l. Results: At time of diagnosis 83% of patients
had sTK levels higher than 5 U/mu l. There was no relationship between
sTK levels and the proportion of medullary blasts. But serum sTK leve
ls correlated with LDH activity (P < 0.0005) and with peripheral leuko
cyte count (P = 0.003). At all times patients with sTK levels < 10 U/m
u l had a higher survival rate than those greater than or equal to 10
U/mu l. Cumulative survival rates in both groups was 69 +/- 10% (< 10
U/mu l) and 43 +/- 11% (greater than or equal to 10 U/mu l), respectiv
ely, after 2 years and 37 +/- 9% (< 10 U/mu l) and 20 +/- 7% (greater
than or equal to 10 U/mu l) after 5 years (P = 0.0002). Multivariate a
nalysis showed that sTK, haemoglobin concentration and proportion of m
edullary blasts were independent prognostic survival factors. Conclusi
ons: Most patients with MDS have an increased sTK level when the diagn
osis is made. This reflects the impaired proliferation and differentia
tion of haematopoiesis. sTK is a simply and rapidly measured prognosti
c indicator for estimating survival probability of patients with MDS.