Revised International Prognostic Scoring System for Myelodysplastic Syndromes
Open Access
- 20 September 2012
- journal article
- Published by American Society of Hematology in Blood
- Vol. 120 (12), 2454-2465
- https://doi.org/10.1182/blood-2012-03-420489
Abstract
The 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.Keywords
This publication has 49 references indexed in Scilit:
- Clonal Architecture of Secondary Acute Myeloid LeukemiaThe New England Journal of Medicine, 2012
- SomaticSF3B1Mutation in Myelodysplasia with Ring SideroblastsThe New England Journal of Medicine, 2011
- Clinical Effect of Point Mutations in Myelodysplastic SyndromesThe New England Journal of Medicine, 2011
- Impact of the degree of anemia on the outcome of patients with myelodysplastic syndrome and its integration into the WHO classification-based Prognostic Scoring System (WPSS)Haematologica, 2011
- Association of Comorbidities With Overall Survival in Myelodysplastic Syndrome: Development of a Prognostic ModelJournal of Clinical Oncology, 2011
- Risk stratification based on both disease status and extra-hematologic comorbidities in patients with myelodysplastic syndromeHaematologica, 2010
- Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study GroupAnnals of Oncology, 2010
- Comorbidities and survival in a large cohort of patients with newly diagnosed myelodysplastic syndromesLeukemia Research, 2009
- Prognostic impact of age and gender in 897 untreated patients with primary myelodysplastic syndromesAnnals of Oncology, 2009
- The hematopoietic stem cell transplantation comorbidity index is of prognostic relevance for patients with myelodysplastic syndromeHaematologica, 2009