Autoimmune disorders are common in myelodysplastic syndrome patients and confer an adverse impact on outcomes.
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.
['Montoro|Julia|J|', 'Gallur|Laura|L|', 'Merchán|Brayan|B|', 'Molero|Antonieta|A|', 'Roldán|Elisa|E|', 'Martínez-Valle|Ferrán|F|', 'Villacampa|Guillermo|G|', 'Navarrete|Mayda|M|', 'Ortega|Margarita|M|', 'Castellví|Josep|J|', 'Saumell|Silvia|S|', 'Bobillo|Sabela|S|', 'Bosch|Francesc|F|', 'Valcárcel|David|D|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001327:Autoimmune Diseases D015415:Biomarkers D005260:Female D006801:Humans D015994:Incidence D015477:Leukemia, Myelomonocytic, Chronic D008297:Male D008875:Middle Aged D009190:Myelodysplastic Syndromes D063868:Patient Outcome Assessment D015995:Prevalence D011379:Prognosis D055815:Young Adult
Autoimmune disorders Myelodysplastic syndrome Chronic myelomonocytic leukemia Immune dysregulation