Table 2.
Associations with Disease Characteristics
| MDS Patients (N=52) | High Tregs (>77/μl; N=9) | High TregCM (>53/μl; N=8) | High TregEM (>6/μl; N=12) | |||
|---|---|---|---|---|---|---|
| Characteristic (N) | n/N (%) | p-value | n/N (%) | p-value | n/N (%) | p-value |
| WHO# | ||||||
| 5q- (2) | 0/2 (0) | ns | 0/2 (0) | ns | 0/2 (0) | ns |
| RA/RARS (12) | 4/12 (33) | ns | 4/12 (33) | ns | 2/12 (17) | ns |
| RAEB-1/2 (8) | 1/8 (13) | ns | 1/8 (13) | ns | 3/8 (38) | ns |
| RCMD/RCMD-RS (18) | 1/18 (6) | ns | 0/18 (0) | ns | 5/18 (28) | ns |
| CMML1/2 (5) | 3/5 (60) | 0.031 | 3/5 (60) | 0.022 | 2/5 (40) | ns |
| MDS-U (7) | 0/7 (0) | ns | 0/7 (0) | ns | 0/7 (0) | ns |
| IPSS† | ||||||
| Low (Low/Int-1) (45) | 7/45 (16) | - | 6/45 (13) | - | 10/45 (22) | - |
| High (Int-2/High) (7) | 2/7 (29) | ns | 2/7 (29) | ns | 2/7 (29) | ns |
| MDAS†† | ||||||
| Low (Low/Int-1) (35) | 3/35 (9) | - | 3/35 (9) | - | 5/35 (14) | - |
| High (Int-2/High) (17) | 6/17 (35) | 0.023 | 5/17 (29) | ns | 7/17 (41) | 0.042 |
| Age (years) | ||||||
| <65 (17) | 2/17 (12) | - | 2/17 (12) | - | 2/17 (12) | - |
| ≥65 (35) | 7/35 (20) | ns | 6/35 (17) | ns | 10/35 (29) | ns |
| History of Cytopenias | ||||||
| Anemia (Hb<9 g/dL) No (23) | 5/23 (22) | - | 4/23 (17) | - | 2/23 (9) | - |
| Yes (29) | 4/29 (14) | ns | 4/29 (14) | ns | 10/29 (34) | 0.046 |
| Neutropenia (<1 × 109/L) | ||||||
| No (31) | 6/31 (19) | - | 5/31 (16) | - | 9/31 (29) | - |
| Yes (21) | 3/21 (14) | ns | 3/21 (14) | ns | 3/21 (14) | ns |
| Thrombocytopenia (<100×109/L) | ||||||
| No (31) | 6/31 (19) | - | 5/31 (16) | - | 9/31 (29) | - |
| Yes (21) | 3/21 (14) | ns | 3/21 (14) | ns | 3/21 (14) | ns |
| No. of Cytopenias<2 (33) | 7/33 (21) | - | 6/33 (18) | - | 8/33 (24) | - |
| No. of Cytopenias ≥2 (19) | 2/19 (11) | ns | 2/19 (11) | ns | 4/19 (21) | ns |
| Complete Blood Count (CBC) | ||||||
| Platelets ≥50* (×109/L) (40) | 3/40* (8) | - | 3/40* (8) | - | 10/40* (25) | - |
| Platelets<50*(×109/L) (12) | 4/12* (33) | ns | 3/12* (25) | ns | 2/12* (17) | ns |
| Hg≥10**(g/dL) (33) | 5/33** (15) | - | 4/33** (12) | - | 4/33** (12) | - |
| Hg<10**(g/dL) (19) | 4/19** (21) | ns | 3/19** (16) | ns | 8/19** (42) | 0.038 |
| Bone Marrow Blasts | ||||||
| Myeloblast<5% (42) | 5/42 (12) | - | 6/42 (14) | - | 6/42 (14) | - |
| Myeloblast≥5% (10) | 4/10 (40) | ns | 2/10 (20) | ns | 6/10 (60) | 0.006 |
| Prior Transfusion | ||||||
| No (28) | 4/28 (14) | - | 4/28 (14) | - | 6/28 (21) | - |
| Yes (24) | 5/24 (21) | ns | 4/24 (17) | ns | 6/24 (25) | ns |
| Karyotype | ||||||
| Normal (35) | 6/35 (17) | ns | 6/35 (17) | ns | 8/35 (23) | ns |
| Abnormal‡: Unfavorable (9) | 3/9 (33) | ns | 2/9 (67) | ns | 2/9 (22) | ns |
| Favorable (8) | 0/8 (0) | ns | 0/8 (0) | ns | 2/8 (25) | ns |
Platelet counts were unavailable for four patients. Two of these patients had high total Tregs, and two had high TregCM numbers.
Hemoglobin levels were unavailable for two patients. One of these had high total Tregs, and one had high TregCM numbers.
World Health Organization (WHO) includes refractory anemia (RA), refractory anemia with ringed sideroblasts (RARS), refractory anemia with multilineage dysplasia (RCMD), refractory anemia with multilineage dysplasia with ringed sideroblasts (RCMD-RS), refractory anemia with excessive blasts (RAEB), chronic myelomonocytic leukemia (CMML) and MDS-unclassified (MDS-U)(1).
International Prognostic Scoring System (IPSS) low risk (IPSS score low or intermediate-1) or high risk (IPSS score intermediate-2 or high).
MD Anderson Scoring System (MDAS) classification lower-risk (low or intermediate-1) or higher-risk (intermediate-2 or high)(2, 3).
Karotype was performed by standard cytogenetics and was available for all 52 patients. Favorable karyotype includes del(5q), -Y, del(20q) and an unfavorable karyotype includes chromosome 7 abnormalities, or complex (≥3 abnormalities) based on IPSS criteria(1).