Prevalence and survival of myelodysplastic syndrome of the refractory anemia type in hospitalized cognitively different geriatric patients

Background: Myelodysplastic syndrome (MDS) is predominantly a disease of ol d age. The number of MDS cases diagnosed over the last 20 yea rs has risen substantially due to increased awareness and improved geriatric care. Altho ugh MDS is increasingly diagnosed, the prevalence and prognosis of early-st age affected elderly are not completely known. Objective: To evaluate the p revalence, characteristics and prognosis of newly diagnosed MDS patients ho spitalized in an acute and subacute geriatric department. Methods: Between 1993 and 1996, 3,275 patients hospitalized in the geriatric department of a teaching hospital for acute care or short-term rehabilitation were investi gated for unexplained hematological abnormalities. Demographic, chronic com orbidities, cause of hospitalization, functional and cognitive status, hema tological and other laboratory parameters were collected. Results: Two hund red and forty-five 17.5%) patients had unexplained cytopenia, macrocytosis or monocytosis, of whom 37 (15%) were diagnosed as having MDS. Only 9 patie nts were hospitalized for evaluation of anemia, 28 for infections, cardiac, cerebrovascular events and other causes. Thirty-four patients had refracto ry anemia (RA), two had RA with ringed sideroblasts and 1 had RA with an ex cess of blasts (RAEB). The follow-up period was up to 70 months. No differe nces were found between demented and cognitively normal patients in age, se x, comorbidities or laboratory parameters. Comparison of survival curves (e xcluding the RAEB case) according to demographic, clinical and hematologica l parameters has shown that only dementia adversely affects survival, compa red to cognitively normal patients (p = 0.024). Conclusions: MDS of the RA type is a com mon and incidental finding in older hospitalized patients. it is a frequent cause of anemia and other hematological abnormalities but ha s less significance on survival rates than dementia, although its full impa ct remains to be determined. Copyright (C) 2000 S. Karger AG. Basel.