Significance of Thrombocytopenia in Myelodysplastic Syndromes: Associations and Prognostic Implications

Purpose: To analyze the incidence and significance of thrombocytopenia in patients with myelodysplastic syndrome (MDS). Patients and Methods: A total of 2517 patients with MDS referred to our institution since 1993 were analyzed, with a specific focus on the incidence and associations of thrombocytopenia. Results: The median age of the study group was 66 years. The median survival was 13 months. Platelet counts <100 x 10(9)/L were noted in 65%, and platelets counts <30 x 10(9)/L in 26%. Each platelets count drop below the range of 200 X 10(9)/L has shown a larger magnitude change in terms of worsening effect on survival. Therefore, smaller ranges of platelet counts of <200 x 10(9)/L were studied. Platelet cutoffs of 30, 50, and 200 x 10(9)/L thus were identified to have significant associations with differences in survival. Significant thrombocytopenia was associated with poor performance, other cytopenias, adverse karyotype, and advanced MDS phases. Thrombocytopenia was associated with worse prognosis; it also was predicted for worse outcome within each of the International Prognostic Scoring System risk groups. Conclusion: Prognosis in MDS is directly associated with the severity of thrombocytopenia.