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

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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.

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Authors and Affiliations

  1. Department of Hematology, University Hospital Vall d’Hebron, University Autònoma of Barcelona (UAB), Barcelona, Spain

    Julia Montoro, Laura Gallur, Brayan Merchán, Antonieta Molero, Elisa Roldán, Mayda Navarrete, Margarita Ortega, Josep Castellví, Silvia Saumell, Sabela Bobillo, Francesc Bosch & David Valcárcel

  2. Experimental Hematology Unit, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain

    Brayan Merchán, Antonieta Molero, Francesc Bosch & David Valcárcel

  3. Department of Internal Medicine, Vall d’Hebron University Hospital, Barcelona, Spain

    Ferrán Martínez-Valle

  4. Oncology Data Science (ODysSey) Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain

    Guillermo Villacampa

Authors
  1. Julia Montoro
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  2. Laura Gallur
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  3. Brayan Merchán
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  14. David Valcárcel
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Corresponding author

Correspondence to David Valcárcel.

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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.

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The authors declare that they have no conflict of interest.

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Montoro, J., Gallur, L., Merchán, B. et al. Autoimmune disorders are common in myelodysplastic syndrome patients and confer an adverse impact on outcomes. Ann Hematol 97, 1349–1356 (2018). https://doi.org/10.1007/s00277-018-3302-0

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  • DOI: https://doi.org/10.1007/s00277-018-3302-0

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