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Rheumatology Advance Access originally published online on February 24, 2004
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Rheumatology 2004; 43: 626-632
Rheumatology Vol. 43 No. 5 (c) British Society for Rheumatology 2004; all rights reserved

Clinical

Autoimmune phenomena in myelodysplastic syndromes: a 4-yr prospective study

S. Giannouli, M. Voulgarelis, E. Zintzaras1, A. G. Tzioufas and H. M. Moutsopoulos

Department of Pathophysiology, Medical School, National University of Athens, 1Biomathematics Laboratory, Medical School, University of Thesssaly, Larisa, Greece.

Correspondence to: H. M. Moutsopoulos, Department of Pathophysiology, Medical School, National University of Athens, M. Asias 75, Goudi 11527 Athens, Greece. E-mail: hmoutsop{at}med.uoa.gr

Objective. To determine the clinical aspects and evolution of autoimmune inflammatory manifestations (AIMs) in patients with myelodysplastic syndrome (MDS) and ascertain the prognostic implications of these manifestations in MDS.

Methods. Seventy patients diagnosed for MDS were enrolled in a prospective cohort study of 4-yr duration. Thirteen patients with AIMs were identified (group A). The remaining 57 MDS patients without AIMs constituted the control group (group B). Demographic, clinical features, laboratory data, treatment and outcome of all these cases were recorded.

Results. On comparing features between the two groups we were unable to identify any particular difference (P >= 0.05) concerning bone marrow blast count [odds ratio (OR) = 0.68], international prognostic scoring system (IPSS) (OR = 1.36), favourable cytogenetic abnormalities (OR = 0.52), leukaemic transformation (OR = 1.30) and survival (P = 0.76). Furthermore there was a significant difference in survival between low vs non-low IPSS patients for both groups (P<0.01).

Conclusion. In a 4-yr prospective study the prognosis of MDS patients with AIMs appeared to be closely related to the IPSS subcategory of the underlying haematological malignancy and not to the autoimmune process.

KEY WORDS: Myelodysplastic syndrome, Vasculitis, Relapsing polychondritis, Arthritis, Autoimmunity.

This paper is dedicated to the memory of the late M. Tsakopoulos, MD, Professor of Experimental Physiology.


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