Concurrent myelodysplastic malignancies and plasma cell neoplasms; a clinicopathological study with prognostic...

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Plasma cell neoplasms (PCN) are infrequently observed in patients with myelodysplastic syndrome (MDS).
• Co-occurrence of PCN with myelodysplastic/myeloproliferative neoplasms (MDS/MPN) is even rarer.
• Understanding the clinicopathologic features of these combined conditions is crucial for diagnosis and prognosis.

Purpose of the Study:

• To investigate the clinicopathologic features of patients with bone marrow myelodysplasia and co-existing plasma cell neoplasms.
• To compare the characteristics of MDS/MPN with PCN (MDS/MPN-PCN) to MDS with PCN (MDS-PCN) and MDS/MPN without PCN.
• To identify prognostic factors associated with overall survival in these patient cohorts.

Main Methods:

• Retrospective analysis of 26 patients with bone marrow myelodysplasia and PCN (21 MDS-PCN, 5 MDS/MPN-PCN).
• Comparison of clinicopathologic features between MDS/MPN-PCN, MDS-PCN, and MDS/MPN without PCN groups.
• Statistical analysis to determine significant differences in fibrosis, survival, and identify independent predictors of survival.

Main Results:

• The MDS/MPN-PCN group exhibited significantly increased reticulin fibrosis compared to both MDS/MPN and MDS-PCN groups.
• MDS/MPN-PCN was associated with worse overall survival compared to MDS-PCN.
• Low hemoglobin (<8 g/dL) and IDH2 somatic mutations were independent predictors of poor overall survival in all MDS/MPN patients.

Conclusions:

• The co-occurrence of plasma cell neoplasms with MDS/MPN is associated with distinct clinicopathologic features, including increased fibrosis.
• These combined neoplasms may portend a worse prognosis, particularly when compared to MDS with PCN.
• Hemoglobin levels and IDH2 mutation status are critical prognostic indicators in MDS/MPN, irrespective of PCN co-occurrence.