Síndromes Mielodisplásicas: enfoque epidemiológico e clínico em serviço de referência de alta complexidade

Abstract

The Myelodysplastic Syndromes (MDS) features a group of clonal hematopoietic diseases evidenced by studies around the world. Epidemiological studies that address the sociodemographic and clinical characteristics, and that approach survival and leukemic evolution are not found in Brazilian literature, which requires investigation of this prevalent disease in the elderly and higher incidence with increasing age. This study aimed to perform a systematic review on MDS and investigate the sociodemographic and clinical characteristics of patients with this disease, to estimate survival and leukemic evolution, in order to characterize this population at a referral center for high complexity. It is a retrospective cohort study conducted with patients with Myelodysplastic Syndromes in the state of Rio Grande do Norte, considered a reference service, from January 2000 to December 2010. Descriptive analysis was conducted using Epi Info 2002, version 3.5.2, probability of survival was calculated with Kaplan-Meier method, using SPSS (Statistic Package for Social Sciences) version 10.0. The calculations of the likelihood of association between the characteristics analyzed and gender were performed using chi-square, chi-square for trend, Fisher, Fisher's exact, Mann Whitney and log rank. The level of significance was 0.05. The study was approved in its ethical and methodological Ethics Committee in Research ECR/HUOL Protocol 432/10. Of the 29 selected patients, there was predominance of elderly, male, with low education, who had anemia as initial symptom. Most were white-skinned people living in their own homes, residents in urban areas and with income less than two minimum wages. All of them used hemoderivatives, especially red blood cells, a frequency of four or more units per month of consumption. Only 20% performed dosage of serum ferritin, all with values referenced above normal. Showed low cumulative probability of survival and leukemic evolution rates of around 27%, with no satisfactory outcome to chemotherapy and no indication of performing bone marrow transplantation as a possible cure. We conclude that it is necessary to conduct research with larger populations, of multicenter character, in order to better evidence sociodemographic and clinical data, with the possibility of characterization throughout the country.