Autoimmune disorders are common in myelodysplastic syndrome patients and confer an adverse impact on outcomes

  • Julia Montoro
  • Laura Gallur
  • Brayan Merchán
  • Antonieta Molero
  • Elisa Roldán
  • Ferrán Martínez-Valle
  • Guillermo Villacampa
  • Mayda Navarrete
  • Margarita Ortega
  • Josep Castellví
  • Silvia Saumell
  • Sabela Bobillo
  • Francesc Bosch
  • David Valcárcel
Original Article

Abstract

The coexistence of autoimmune disorders (AD) in patients with myelodysplastic syndrome (MDS) or chronic myelomonocytic leukemia (CMML) has been widely recognized, although with distinct results regarding their prevalence and impact on the outcomes of the underlying hematological process. This study was aimed to analyze the prevalence, clinical characteristics, and outcomes of MDS with AD in a series of 142 patients diagnosed with MDS and CMML. AD was ascertained by both the presence of clinical symptoms or compatible serological tests. In total, 48% patients were diagnosed as having AD, being hypothyroidism the most commonly reported clinical AD (8%) and antinuclear antibodies the most frequent serological parameter identified (23.2%). The presence of AD was associated with female gender, lower hemoglobin levels, and higher IPSS-R. Overall survival for patients with AD was inferior to those with no AD (69 vs. 88% at 30 months; HR 2.75, P = 0.008). Notably, clinical but not isolated immune serological parameters had an impact on the outcomes of patients with AD. Finally, in a multivariate analysis, the presence of AD (HR 2.26) along with disease risk categories (very low and low vs. intermediate, high, and very high IPSS-R; HR 4.62) retained their independent prognostic value (P < 0.001). In conclusion, AD are prevalent in MDS and CMML patients and have prognostic implications, especially in lower-risk MDS patients.

Keywords

Myelodysplastic syndrome Chronic myelomonocytic leukemia Autoimmune disorders Immune dysregulation 

Notes

Compliance with ethical standards

This study was approved by the central ethic committee of the University Hospital Vall d’Hebron, Barcelona, and conducted in accordance with the Declaration of Helsinki. All patients provided written informed consent.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Julia Montoro
    • 1
  • Laura Gallur
    • 1
  • Brayan Merchán
    • 1
    • 2
  • Antonieta Molero
    • 1
    • 2
  • Elisa Roldán
    • 1
  • Ferrán Martínez-Valle
    • 3
  • Guillermo Villacampa
    • 4
  • Mayda Navarrete
    • 1
  • Margarita Ortega
    • 1
  • Josep Castellví
    • 1
  • Silvia Saumell
    • 1
  • Sabela Bobillo
    • 1
  • Francesc Bosch
    • 1
    • 2
  • David Valcárcel
    • 1
    • 2
  1. 1.Department of HematologyUniversity Hospital Vall d’Hebron, University Autònoma of Barcelona (UAB)BarcelonaSpain
  2. 2.Experimental Hematology UnitVall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain
  3. 3.Department of Internal MedicineVall d’Hebron University HospitalBarcelonaSpain
  4. 4.Oncology Data Science (ODysSey) GroupVall d’Hebron Institute of Oncology (VHIO)BarcelonaSpain

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