Mersin Bölgesinde Yaşayan Yüksek Riskli Myelodisplastik Sendrom Hastalarında Kronik Hastalık Varlığının Sağ Kalım Üzerine Etkisi

Amaç: Myelodisplastik sendrom hematopoetik sistemin klonal kök hücre hastalığıdır. Myelodisplastik sendrom, 65 yaş üzerinde erkeklerde daha sık görülen bir hastalıktır. Prognoz tayininde sitogenetik inceleme, kemik iliğindeki blast sayısı ve sitopeninin derecesinin eklenmesi ile Uluslarası Prognoz Puanlama Sistemi (IPSS) kullanılır. Yüksek riskli myelodisplastik sendrom hastalarında kronik hastalıkların sağ kalım üzerine etkisi ve prognostik değerini tespit etmek üzere bu çalışma planlandı.Yöntem: 2011 ocak ve 2019 ocak yılları arasında Mersin Üniversitesi Tıp Fakültesi Hematoloji polikliniğinde MDS tanılı hastalar retrospektif olarak değerlendirildi. 18-96 yaş arası, kronik hastalık varlığı tanı anında veya öncesinde mevcut olan, kemik iliği biyopsisi ile MDS tanısı konan 124 hasta çalışmaya alındı. Kategorik değişkenler sayı ve yüzde olarak belirtildi. Mortalite ile ilişkili bulgular univariable Cox regression analiz ile değerlendirildi.Bulgular: Hastaların ortalama yaşı 67 yıldı. Kardiyak hastalık, serebrovasküler hastalık, kanser ve kronik obstruktif akciğer hastalığı mortalite riskini arttıran olası risk faktörleri olarak saptandı. Yaşın 1 yıl artması 1,03 kat mortalite riskini arttırdığı saptandı. Kardiyak hastalığı olanlar olmayanlara kıyasla 1,60 kat mortalite riskine sahipti. KOAH olanlar olmayanlara kıyasla 1,78 kat mortalite riskini sahipti. Sonuç: İleri yaş, kardiyak hastalık, serebrovasküler hastalık, kanser ve kronik obstruktif akciğer hastalığı mortalite riskini arttıran olası risk faktörleri olarak saptandı. Bu çalışma MDS üzerine Mersin bölgesinden yapılmış tek merkezli en fazla hasta sayısına sahip olan ilk çalışma olması nedeni ile önemlidir. Bununla birlikte elde ettiğimiz bu verilerin Mersin’de yaşayan MDS hastalarında kronik hastalık varlığının mortaliteye etkisi ve en uygun tedavi seçeneklerini belirlemeye ışık tutacağını düşünmekteyiz.

Anahtar Kelimeler:

myelodisplastik sendrom, kronik hastalık

The Effect of Chronic Disease on Survival in High-risk Myelodysplastic Syndrome Patients Living in Mersin

Aim: Myelodysplastic syndrome is a clonal stem cell disease of the hematopoietic system. Myelodysplastic syndrome is a more common disease in men over 65 years of age. Prognosis is determined by the addition of cytogenetic examination, bone marrow blast number and degree of cytopenia and the International Prognosis Scoring System (IPSS). This study was planned to determine the effect of chronic diseases on survival and prognostic value in patients with high risk myelodysplastic syndrome.Method: Between January 2011 and January 2019, patients diagnosed with MDS in the Hematology outpatient clinic of Mersin University Medical Faculty were evaluated retrospectively. A total of 124 patients aged 18-96 years, who were present before or at the time of diagnosis of chronic disease, were diagnosed as MDS by bone marrow biopsy. Categorical variables were expressed as numbers and percentages. Mortality-related findings were evaluated by univariable Cox regression analysis.Results: The mean age of the patients was 67 years. Cardiac disease, cerebrovascular disease, cancer and chronic obstructive pulmonary disease were identified as possible risk factors increasing the mortality risk. It was found that increasing age 1 year increased the risk of mortality 1.03 times. Those with cardiac disease had a 1.60-fold mortality risk compared to those without. Those with COPD had a 1.78-fold mortality risk compared to those without.. Conclusion: Advanced age, cardiac disease, cerebrovascular disease, cancer and chronic obstructive pulmonary disease were identified as possible risk factors that increased mortality. This study is important because it is the first study with the highest number of patients with single center in Mersin region on MDS. However, we think that these data will shed light on the effect of the presence of chronic disease on mortality and the most appropriate treatment options in MDS patients living in Mersin.

Keywords:

Myelodysplastic syndrome chronic disease, prognosis,

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