Medical Oncology

, 35:143 | Cite as

The critical role of comorbidities and polypharmacy in lower risk myelodysplastic patients: is there any difference between countries?

  • Priscila da Silva MendonçaEmail author
  • Ronald Pinheiro Feitosa
  • Silvia Maria Meira Magalhães
Letter to the Editor

To the editor,

We read with interest the paper recently published by Castelli et al. [1], who assessed the important relationship between anemia, transfusion dependency, comorbidities, and polypharmacy in 155 low-risk myelodysplastic syndrome (MDS) patients from two centers in Milan, Italy. Therefore, we felt very motivated to discuss and complement their findings in a comparative study in Brazilian patients.

MDS is a prevalent clonal hematopoietic stem cell disorder that affects predominantly older individuals, who are prone to developing comorbidities. Both, multiple comorbidities and age, have been shown to be important negative prognostic factors in low-risk MDS patients. Recently, Brunner et al. [2] showed that MDS patients were more likely to die of cardiovascular diseases than population in general, in a large American cohort. Evaluating and controlling extra-hematological comorbidities is important to enable aggressive therapeutic strategies (i.e., hypomethylating agents,...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Castelli R, Schiavon R, Deliliers GL. The impact of anaemia, transfusion dependency, comorbidities and polypharmacy in elderly patients with low-risk myelodysplastic syndromes. Med Oncol. 2018;8;35(3):33. Scholar
  2. 2.
    Brunner AM, Blonquist TM, Hobbs GS, Amrein PC, Neuberg DS, Steensma DP, Abel GA, Fathi AT. Risk and timing of cardiovascular death among patients with myelodysplastic syndromes. Blood Adv. 2017;18:2032–40. Scholar
  3. 3.
    Della Porta MG, Malcovati L, Strupp C, Ambaglio I, Kuendgen A, Zipperer E, Travaglino E, Invernizzi R, Pascutto C, Lazzarino M, Germing U, Cazzola M. Risk stratification based on both disease status and extra-hematologic comorbidities in patients with myelodysplastic syndrome. Haematologica. 2011;96(3):441–9. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Priscila da Silva Mendonça
    • 1
    Email author
  • Ronald Pinheiro Feitosa
    • 1
  • Silvia Maria Meira Magalhães
    • 1
  1. 1.Cancer Cytogenomic Laboratory, Post-graduate Program in Medical ScienceFederal University of CearaFortalezaBrazil

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