Prognostic Features of Myelodysplastic Syndrome Patients Aged < 50 years: Update of a Single Institution Experience.

Abstract Less than 10% of MDS patients are younger than 50 years. A series of 91 younger patients (median age 44 years with female prevalence) are reported and compared with elderly patients. Frequent karyotypic changes were trisomy 8 (10.5%) and monosomy 7 (5%). Twenty-three patients had occupational exposure to potential mutagens (benzene and solvents), with a male predominance, higher frequency of RCMD (52%) and higher frequency of monosomy 7 (13%). At a median follow-up of 72 months, 22 patients (24%) evolved to acute leukemia with higher frequency being observed among the exposed cohort (39% vs 19% of non-exposed). Unfavorable factors for overall survival were: age > 40 years, >5% of blasts and trilinear bone marrow involvement, intermediate-high WPSS risk. Present results suggest that younger MDS could be identified as a distinct subset: for patients belonging to low/intermediate-I risk, due to low transformation rate, aggressive approaches should rarely be recommended.