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Causes of death in 2877 patients with myelodysplastic syndromes

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Abstract

Patients with myelodysplastic syndromes face a poor prognosis. The exact causes of death have not been described properly in the past. We performed a retrospective analysis of causes of death using data of 3792 patients in the Düsseldorf registry who have been followed up for a median time of 21 months. Medical files as well as death certificates were screened and primary care physicians were contacted. Death after AML evolution, infection, and bleeding was considered to be clearly disease-related. Further categories of causes of death were heart failure, other possibly disease-related reasons, such as hemochromatosis, disease-independent reasons as well as cases with unclear causes of death. Median age at the time of diagnosis was 71 years. At the time of analysis, 2877 patients (75.9 %) had deceased. In 1212 cases (42.1 %), the exact cause of death could not be ascertained. From 1665 patients with a clearly documented cause of death, 1388 patients (83.4 %) succumbed directly disease-related (AML (46.6 %), infection (27.0 %), bleeding (9.8 %)), whereas 277 patients (16.6 %) died for reasons not directly related with myelodysplastic syndromes (MDS), including 132 patients with cardiac failure, 77 non-disease-related reasons, 23 patients with solid tumors, and 45 patients with possibly disease-related causes like hemochromatosis. Correlation with IPSS, IPSS-R, and WPSS categories showed a proportional increase of disease-related causes of death with increasing IPSS/IPSS-R/WPSS risk category. Likewise, therapy-related MDS were associated with a higher percentage of disease-related causes of death than primary MDS. This reflects the increasing influence of the underlying disease on the cause of death with increasing aggressiveness of the disease.

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Authors and Affiliations

  1. Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany

    Kathrin Nachtkamp, Romina Stark, Corinna Strupp, Andrea Kündgen, Rainer Haas, Norbert Gattermann & Ulrich Germing

  2. Department of Hematology, Oncology and Clinical Immunology, St. Johannes Hospital, Duisburg, Germany

    Aristoteles Giagounidis & Carlo Aul

  3. Department of Human Genetics, Heinrich-Heine-University, Düsseldorf, Germany

    Barbara Hildebrandt

Authors
  1. Kathrin Nachtkamp
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  2. Romina Stark
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  3. Corinna Strupp
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  4. Andrea Kündgen
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  5. Aristoteles Giagounidis
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  6. Carlo Aul
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  7. Barbara Hildebrandt
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  8. Rainer Haas
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  9. Norbert Gattermann
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  10. Ulrich Germing
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Correspondence to Kathrin Nachtkamp.

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Nachtkamp, K., Stark, R., Strupp, C. et al. Causes of death in 2877 patients with myelodysplastic syndromes. Ann Hematol 95, 937–944 (2016). https://doi.org/10.1007/s00277-016-2649-3

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  • DOI: https://doi.org/10.1007/s00277-016-2649-3

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