Revised International Prognostic Scoring System for Myelodysplastic Syndromes

Blood - Tập 120 - Trang 2454-2465 - 2012
Peter L. Greenberg1, Heinz Tuechler2, Julie Schanz3, Guillermo Sanz4, Guillermo Garcia-Manero5, Francesc Solé6, John M. Bennett7, David Bowen8, Pierre Fenaux9, Francois Dreyfus10, Hagop Kantarjian5, Andrea Kuendgen11, Alessandro Levis12, Luca Malcovati13, Mario Cazzola13, Jaroslav Cermak14, Christa Fonatsch15, Michelle M. Le Beau16, Marilyn L. Slovak17, Otto Krieger18
1Stanford University Cancer Center, Stanford, CA
2Hanusch Hospital, Boltzmann Institute for Leukemia Research, Vienna, Austria
3Georg August Universität, Göttingen, Germany
4Hospital Universitario la Fe, Valencia, Spain
5The University of Texas MD Anderson Cancer Center, Houston, TX
6Hospital del Mar, Barcelona, Spain
7James P. Wilmont Cancer Center, University of Rochester Medical Center, Rochester, NY
8St. James's University Hospital, Leeds, United Kingdom
9Hôpital Avicenne, Assistance Publique–Hôpitaux de Paris (AP-HP)/University Paris XIII, Bobigny, France
10Hôpital Cochin, AP-HP University of Paris V, Paris, France
11Heinrich-Heine University Hospital, Düsseldorf, Germany
12Antonio e Biagio e C Arrigo Hospital, Alessandria, Italy
13Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo and University of Pavia, Pavia, Italy
14Institute of Hematology and Blood Transfusion, Praha, Czech Republic
15Medical University of Vienna, Vienna, Austria
16University of Chicago Comprehensive Cancer Research Center, Chicago, IL
17Quest Diagnostics Nichols Institute, Chantilly, VA
18Elisabethinen Hospital, Linz, Austria

Tóm tắt

AbstractThe International Prognostic Scoring Sytem (IPSS) is an important standard for ssessing prognosis of primary untreated adult patients with myelodysplastic syndromes (MDS). To refine the IPSS, MDS patient databases from international institutions were coalesced to assemble a much larger combined database (Revised-IPSS [IPSS-R], n = 7012, IPSS, n = 816) for analysis. Multiple statistically weighted clinical features were used to generate a prognostic categorization model. Bone marrow cytogenetics, marrow blast percentage, and cytopenias remained the basis of the new system. Novel components of the current analysis included: 5 rather than 3 cytogenetic prognostic subgroups with specific and new classifications of a number of less common cytogenetic subsets, splitting the low marrow blast percentage value, and depth of cytopenias. This model defined 5 rather than the 4 major prognostic categories that are present in the IPSS. Patient age, performance status, serum ferritin, and lactate dehydrogenase were significant additive features for survival but not for acute myeloid leukemia transformation. This system comprehensively integrated the numerous known clinical features into a method analyzing MDS patient prognosis more precisely than the initial IPSS. As such, this IPSS-R should prove beneficial for predicting the clinical outcomes of untreated MDS patients and aiding design and analysis of clinical trials in this disease.

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Blood

Tập 120

2454-2465

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