Evaluation of the prognostic significance of Eosinophilia and Basophilia in a larger cohort of patients with myelodysplastic syndromes

• Published in: Cancer 2010-05, Vol.116 (10), p.2372-2381
• Main Authors: Wimazal, Friedrich, Germing, Ulrich, Kundi, Michael, Noesslinger, Thomas, Blum, Sabine, Geissler, Philipp, Baumgartner, Christian, Pfeilstoecker, Michael, Valent, Peter, Sperr, Wolfgang R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Arrests; Basophils; Biological and medical sciences; Cancer; Disease Progression; Eosinophilia - complications; eosinophils; Female; Follow-Up Studies; Hematologic and hematopoietic diseases; Humans; International Prognostic Scoring System; lactate dehydrogenase; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukocyte Count; Leukocyte Disorders - complications; Leukopenia - complications; light microscopy; Male; Medical sciences; Middle Aged; myelodysplastic syndromes; Myelodysplastic Syndromes - complications; Myelodysplastic Syndromes - mortality; Prognosis; prognostication; Risk Assessment; Survival; Tumors
• ISSN: 0008-543X; 1097-0142; 1097-0142
• DOI: 10.1002/cncr.25036

BACKGROUND: Lineage involvement and maturation arrest are considered to have prognostic significance in patients with myelodysplastic syndromes (MDS). However, although the prognostic value of neutropenia, thrombocytopenia, and monocytosis have been documented, little is known about the impact of eosinophils and basophils. METHODS: The authors examined the prognostic significance of eosinophils and basophils in 1008 patients with de novo MDS. Patients were enrolled from 3 centers of the Austrian‐German MDS Working Group and were analyzed retrospectively. Blood eosinophils and basophils were quantified by light microscopy, and their impact on survival and leukemia‐free survival was calculated by using Cox regression. RESULTS: Eosinophilia (eosinophils >350/μL) and basophilia (basophils >250/μL) predicted a significantly reduced survival (P < .05) without having a significant impact on leukemia‐free survival. In multivariate analysis, eosinophilia and basophilia were identified as lactate dehydrogenase (LDH)‐independent prognostic variables with International Prognostic Scoring System (IPSS)‐specific impact. Although elevated LDH was identified as a major prognostic determinant in IPSS low‐risk, intermediate‐1 risk, and high‐risk subgroups, the condition “eosinophilia and/or basophilia” was identified as a superior prognostic indicator in the IPSS intermediate‐2 risk subgroup. CONCLUSIONS: The evaluation of eosinophils and basophils in patients with MDS was helpful and may complement the spectrum of variables to optimize prognostication in MDS. Cancer 2010. © 2010 American Cancer Society. Although the prognostic significance of neutropenia and thrombocytopenia is well established in myelodysplastic syndromes, little is known about the prognostic impact of eosinophils and basophils. In the current study, the authors identified eosinophilia and basophilia as additional significant prognostic variables in myelodysplastic syndromes that may have implications for prognostication in daily clinical practice.