PB0749 - Significance of platelet count at diagnosis and its association with survival in Myelodysplastic Syndrome patients; an experience from Pakistan

Background: Myelodysplastic syndromes (MDS) are heterogeneous group of clonal hematopoietic disorder characterized by dysplastic progenitors, peripheral cytopenias and tendency to evolve into acute myeloid leukaemia. Thrombocytopenia is a significant consequence of ineffective hematopoiesis with decreased overall survival. However, there is a scarcity of data with none of the study reported in Pakistan.

Aims: To observe the association of overall survival of MDS patients presenting with or without thrombocytopenia at diagnosis.

Methods: A retrospective cohort study was conducted at NIBD PECHS campus where MDS patients were recruited from 2018- 2021. Kruskal Wallis test was applied to observe the difference in survival days and Kaplan Meier Survival analysis was performed to observe the survival in each platelet category. P-value of < 0.05 was considered to be statistically significant.

Results: A total of 65 patients were analyzed. Median age (IQR) of patients was 60 (37) years with male predominance 41(63%). 18(28%) patients were MDS-EB1 and majority of patients were Intermediate risk IPSS. Overall median (IQR) hemoglobin (Hb) g/dl, total leucocyte count x109/L and platelet count (PLT) x109/L at diagnosis was 8(3.1), 4.2 (4.0) and 44 (101) respectively. Overall survival in patients with PLT < 25 and with PLT 51-100 was 57%, with PLT 25-50 was 70% and with PLT > 100 was 91%. Median (IQR) survival days with < 25 PLT was 79 (331), with 25-50 PLT was 66(577), 51-100 was 210 (301) and with > 100 it was 343 (498) days. The difference in mortality and survival days was not found significant between platelet categories (P-value >0.05).

Conclusion(s): The median difference in survival days was higher in patients who were not presented with thrombocytopenia at diagnosis however it was not found significant. Further studies with large sample size are needed to evaluate the significance of thrombocytopenia presentation at baseline and its impact on survival in our patients.