The clinical characteristics, gene mutations and outcomes of myelodysplastic syndromes with diabetes mellitus

Abstract

Abstract Purpose: Diabetes mellitus (DM) is the second most common comorbidity in myelodysplastic syndromes (MDS). The purpose of the study was to investigate the clinical characteristics of MDS patients with DM. Methods: A retrospective analysis was performed on the clinical data of 958 MDS patients with and without DM. Clinical data, including genetic changes, overall survival (OS), leukemia-free survival (LFS) and infection, were analyzed. Results: Among 958 patients, 202 (21.1%) had DM. TET2and SF3B1 mutations occurred more frequently in the DM group than in the non-DM group (p = 0.0124 and p = 0.0009, respectively). Compared to non-DM patients, MDS patients with DM had poor OS and LFS (p < 0.0001 and p = 0.0003, respectively), especially in the lower-risk group. In multivariate analysis, DM independently predicted OS (HR 1.369 CI 1.078-1.738, p = 0.010). Meanwhile, DM was an independent risk factor for bacterial infection (HR 2.055 CI 1.415-2.984, p = 0.000) and fungal infection (HR 2.146 CI 1.422-3.238, p = 0.000) in MDS. Conclusions: MDS patients with DM have an inferior prognosis and higher infection incidence, with TET2 and SF3B1 mutations being more frequent in those cases.