Secondary pulmonary alveolar proteinosis complicating myelodysplastic syndrome results in worsening of prognosis: a retrospective cohort study in Japan
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- 作者：Haruyuki Ishii (17)
John F Seymour (18)
Ryushi Tazawa (19)
Yoshikazu Inoue (20)
Naoyuki Uchida (21)
Aya Nishida (21)
Yoshihito Kogure (22)
Takeshi Saraya (17)
Keisuke Tomii (23)
Toshinori Takada (24)
Yuko Itoh (19)
Masayuki Hojo (25)
Toshio Ichiwata (26)
Hajime Goto (17)
Koh Nakata (19) - 关键词：Proteinosis ; Myelodysplastic syndrome ; GM ; CSF ; WPSS ; Secondary pulmonary alveolar proteinosis ; MDS ; PAP ; Refractory anemia
- 刊名：BMC Pulmonary Medicine
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：14
- 期：1
- 全文大小：261 KB
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29. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2466/14/37/prepub - 作者单位：Haruyuki Ishii (17)
John F Seymour (18)
Ryushi Tazawa (19)
Yoshikazu Inoue (20)
Naoyuki Uchida (21)
Aya Nishida (21)
Yoshihito Kogure (22)
Takeshi Saraya (17)
Keisuke Tomii (23)
Toshinori Takada (24)
Yuko Itoh (19)
Masayuki Hojo (25)
Toshio Ichiwata (26)
Hajime Goto (17)
Koh Nakata (19)
17. Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 shinkawa, Mitaka-shi, Tokyo, 1818611, Japan
18. Department of Haematology, Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, Victoria, 8006, Australia
19. Bioscience Medical Research Center, Niigata University Medical & Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 9518520, Japan
20. Diffuse Lung Diseases and Respiratory Failure, Clinical Research Center, NHO Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai, Osaka, 5918555, Japan
21. Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 1058470, Japan
22. Department of Respiratory Medicine, NHO Nagoya Medical Center, 4-1-1 Sannomal, Naka-ku, Nagoya, 4600001, Japan
23. Department of Pulmonary Medicine, Kobe City General Hospital, 4-6 Minatojimanakamachi, Chuo-ku, Kobe-city, Hyogo, 6500046, Japan
24. Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 9518520, Japan
25. Division of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 1628655, Japan
26. Department of Respiratory Medicine, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo, 1930998, Japan - ISSN：1471-2466
文摘
Background Secondary pulmonary alveolar proteinosis (sPAP) is a very rare lung disorder comprising approximately 10% of cases of acquired PAP. Hematological disorders are the most common underlying conditions of sPAP, of which 74% of cases demonstrate myelodysplastic syndrome (MDS). However, the impact of sPAP on the prognosis of underlying MDS remains unknown. The purpose of this study was to evaluate whether development of sPAP worsens the prognosis of MDS. Methods Thirty-one cases of sPAP and underlying MDS were retrospectively classified into mild and severe cases consisting of very low-/low-risk groups and intermediate-/high-/very high-risk groups at the time of diagnosis of MDS, according to the prognostic scoring system based on the World Health Organization classification. Next, we compared the characteristics, disease duration, cumulative survival, and prognostic factors of the groups. Results In contrast to previous reports on the prognosis of MDS, we found that the cumulative survival probability for mild MDS patients was similar to that in severe MDS patients. This is likely due to the poor prognosis of patients with mild MDS, whose 2-year survival rate was 46.2%. Notably, 75% and 62.5% of patients who died developed fatal infectious diseases and exacerbation of PAP, respectively, suggesting that the progression of PAP per se and/or PAP-associated infection contributed to poor prognosis. The use of corticosteroid therapy and a diffusing capacity of the lung for carbon monoxide of less than 44% were predictive of poor prognosis. Conclusion Development of sPAP during the course of MDS may be an important adverse risk factor in prognosis of patients with mild MDS.