142nd APHA Annual Meeting and Exposition

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Clinical characteristics and outcome in a large sample of MDS patients

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Samantha M. Kerath, MS , Department of Population Health, The Feinstein Institute for Medical Research, Great Neck, NY
Mikkael A. Sekeres, MD, MS , Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
Jon P. Fryzek, PhD, MPH , EpidStat Institute, Rockville, MD
Batsirai T. Mutetwa, MPH , GlaxoSmithKline, London, United Kingdom
Chandrika Sreekantaiah, PhD, FACMG , Division of Cytogenetics and Molecular Pathology, North Shore-LIJ Health System, Manhasset, NY
Christopher R. Mason, DO , Internal Medicine, Hofstra North Shore-LIJ Health System, Manhasset, NY
Jonathan Kolitz, MD , Department of Hematologic Oncology, North Shore-LIJ Health System, Lake Success, NY
Emanuela Taioli, MD, PhD , Population Health, North Shore LIJ-Hofstra School of Medicine, Great Neck, NY
Background: The myelodysplastic sydromes (MDS) are a heterogeneous group of hematopoietic disorders which have poor overall survival. As its incidence in the general population is only 4.6 out of 100,000, there is a paucity of epidemiological studies on the disorders.  We combined three data sets from Pennsylvania, Ohio and New York to study determinants of outcome.

Methods: De-identified patient and clinical data for 1192 incident cases of MDS from three sites were collected non-concurrently, from 1990-2010. All patients were followed from the date of diagnosis to transformation to Acute Myeloid Leukemia (AML), death, or end of the study period (2010). The median of the population baseline blood parameters was used to create cut offs for analyses for hemoglobin levels, neutrophil count, and platelet count. Clinical cutoff values were also utilized. Descriptive and survival analyses were performed.

Results:  The study population was 90.5% White, 60.6% male, and ever smokers in 57.8% of cases. Mean age at diagnosis was 68 years. Males were significantly more likely to be ever smokers than females (p<.0001); a significantly higher proportion of non-White patients was observed among males compared with females. Factors significantly associated with survival at multivariate analysis were being female [HR adj: 0.79 (95% CI: 0.66-0.95)], and having a neutrophil count > 1.8 x 109/L, the median value for this sample [HR adj: 0.75 (0.6-0.93)].

Conclusions: Among MDS patients, females and patients with higher neutrophil counts have better survival than males or patients with lower neutrophil counts, respectively, and this may reflect differences in the biology of the disease, or in environmental exposure.

Learning Areas:

Basic medical science applied in public health

Learning Objectives:
Describe significant factors associated with prognosis in MDS patients.

Keyword(s): Epidemiology, Outcomes Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a Project Coordinator on large study datasets with Dr. Emanuela Taioli for 2 years. I have worked on the multi-center MDS study for 2 years as well, and have read all available epidemiological and clinical publications since becoming involved in the study. My interests are in the further identification of factors which may affect MDS prognosis and clinical presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.