Myelodysplastic Syndromes in Ukraine: A 25-year Single Institution Analysis

• Main Authors: T.S. Ivanivskaya, D.F. Gluzman, A.A. Philchenkov, S.V. Koval, M.P. Zavelevich
• Format: Article
• Language: English
• Published: PAGEPress Publications 2020-09-01
• Series: Hematology Reports
• Online Access: https://www.pagepress.org/journals/index.php/hr/article/view/8902
• ISSN: 2038-8322; 2038-8330

Background and Objectives: Until recently, MDS have not been reported as the separate entry in National Cancer Registry of Ukraine. According to the latest edition of Cancer in Five Continents (2017), the age-standardized MDS incidence in Ukraine in 2008–2012 was 0.2 and 0.1 per 100,000 of male and female population, respectively. The aim of the study is to present the actual data on MDS based on the data of the Ukrainian Reference Laboratory (URL) operating at R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology. Methods: The patients with suspected MDS were referred to from all the regions of Ukraine. The diagnostic activity of the URL covers about one third of the total hematological malignancies in Ukraine. The refined diagnosis of MDS was provided starting from 1996 based on cytomorphology, cytochemistry, and immunophenotyping in accordance to the recent WHO 2016 and ICD-11 classifications. Results: The overall number of adult patients with various forms MDS since 1996 up to present totaled to 629 (303 males, median age 63; 326 females, median age 60). The annual number of MDS grew rapidly, although such abrupt growth seems to be a consequence of the increased alertness to MDS. This situation is similar to the trend described for MDS in Japan indicating the incompleteness of earlier MDS records. While according to Cancer in Five Continents the relative contribution of MDS in the overall structure of hematological malignancies in Ukraine was about 0.62%, our recent data demonstrate that MDS patients account for about 5.5% of all oncohematological patients filed in the URL. The proportion of MDS among all female patients with hematopoietic malignancies diagnosed in the URL exceeds slightly that in male patients. The trend of decreasing medium age of MDS patients at presentation could be followed throughout all 25-year period of observation. The relative contribution of MDS in overall pattern of hematological malignancies diagnosed in the regions of Ukraine contaminated with radionuclides does not differ significantly from that in the rest of the country. At the same time, the proportion of the diagnosed AML among all forms of hematological malignancies in the contaminated regions shifts slightly upwards (33.5% vs. 28.3% in non-contaminated areas). Conclusion: In Ukraine, MDS incidence is currently being underestimated resulting in the serious undercount of the total incidence of hematological malignancies. The knowledge of the true incidence of different MDS types, diagnosed according to the recent classifications, especially in the regions of Ukraine contaminated by radionuclides due to Chernobyl accident is important taking into account the data on the life-long increased risk of MDS in populations exposed to the low doses of ionizing radiation.