Praveen Malayath1
BACKGROUND Myelodysplastic syndromes are clonal marrow stem cell disorders characterised by ineffective haemopoiesis leading to blood cytopenias. Various prognostic parameters have been used to assess the prognosis of the disease like age, gender, IPSS score, modified IPSS score, serum albumin, Red Cell Distribution Width (RDW), serum ferritin and Lactate Dehydrogenase (LDH). Multiple studies from the west have shown serum albumin levels at presentation to correlate well with prognosis of patients. Studies from India investigating the levels of serum albumin with prognosis of patients with myelodysplastic syndrome are scanty. The aim of this study was to investigate the relationship of serum albumin levels at presentation of patients and the consequent development of complications and death that occurred in the follow-up period of patients with myelodysplastic syndrome. METHODS For this purpose, we studied 117 consecutive confirmed cases of myelodysplastic syndrome that presented to the Department of Medicine and Haematology in Calicut Government Medical College between July 2009 and June 2013. Serum albumin levels were taken on diagnosis. All patients were followed up till December 2014 and subsequently developing complications both outpatient and inpatient) along with deaths that occurred were studied. RESULTS Although, only 40.2% of patients with myelodysplastic syndrome had low serum albumin at presentation, the undifferentiated subtype, RAEB-2 subtype and RAEB-1 had a statistically significant low serum albumin levels. Of the 47 patients who had low serum albumin, 33 patients had developed complications during the course of the illness. Of the 70 patients who had normal serum albumin, 35 had developed complications, which was statistically significant. CONCLUSIONS A low level of serum albumin (<3.5 mg%) at presentation in cases of myelodysplastic syndrome was statistically associated with poor prognostic subtypes of myelodysplastic syndrome and in turn was associated with high levels of complications and mortality during the course of illness.
