PROGNOSTIC-SIGNIFICANCE OF SERUM THYMIDIN E KINASE IN THE MYELODYSPLASTIC SYNDROME

Citation
C. Aul et al., PROGNOSTIC-SIGNIFICANCE OF SERUM THYMIDIN E KINASE IN THE MYELODYSPLASTIC SYNDROME, Deutsche Medizinische Wochenschrift, 121(37), 1996, pp. 1113-1118
Citations number
27
Categorie Soggetti
Medicine, General & Internal
Volume
121
Issue
37
Year of publication
1996
Pages
1113 - 1118
Database
ISI
SICI code
Abstract
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.