Elevated mature monocytes in bone marrow accompanied with a higher IPSS-R score predicts a poor prognosis in myelodysplastic syndromes

Abstract

Background: Myelodysplastic syndromes (MDS) is a group of heterogeneousmyeloid clonal diseases originating from hematopoietic stem cells. Clinically, elevated mature monocyte is often observed, but its clinical value still remains unclear.Methods: We retrospectively analyzed a cohort of 235 MDS patients to explore the prognostic value of the percentage of mature monocyte in bone marrow (PMMBM). All patients were divided into elevated PMMBM group and the normal group by 6% PMMBM as the cut-off value. Results: Our results showed that PMMBM>6% was associated with inferior overall survival (OS) (P=0.007) and leukemia-free survival (LFS) (P=0.016) along with higher Revised International Prognostic Scoring System (IPSS-R) score (P<0.0001) and higher frequency of IDH2 mutation (P=0.001). Multivariate analyses showed that besides older age (>60 years), lower hemoglobin level (<10 g/dl), higher bone marrow blast percentage (>5%), poorer karyotype, elevated PMMBM was also an independent adverse prognostic factor for OS in MDS (P=0.049). Conclusions: These findings indicate that increased PMMBM accompanied with a higher IPSS-R score may predict a poor outcome and provide a novel evaluation factor for MDS patients especially when their karyotype analyses fail.

Monocytosis at the time of diagnosis has a negative prognostic impact in myelodysplastic syndromes with less than 5% bone marrow blasts

“…Patients exhibiting a CMML-like phenotype in the bone marrow also had a higher incidence of constitutional symptoms. Another study on bone marrow monocytosis [9] confirmed these findings and concluded that an increase in mature monocytes in the bone marrow is associated with inferior prognosis in patients with all types of MDS. Since our study included only patients without excess blasts, patient characteristics differed substantially between our cohort and the two aforementioned studies.…”