A prognostic score for patients with lower risk myelodysplastic syndrome
- 13 December 2007
- journal article
- research article
- Published by Springer Science and Business Media LLC in Leukemia
- Vol. 22 (3), 538-543
- https://doi.org/10.1038/sj.leu.2405070
Abstract
Current prognostic models for myelodysplastic syndromes (MDS) do not allow the identification of patients with lower risk disease and poor prognosis that may benefit from early therapeutic intervention. We evaluated the characteristics of 856 patients with low or intermediate-1 disease by the International Prognostic Scoring System. Mean follow-up was 19.6 months (range 1-262). Of these patients, 87 (10%) transformed to acute myelogenous leukemia, and 429 (50%) had died. By multivariate analysis, characteristics associated with worse survival (P<0.01) were low platelets, anemia, older age, higher percent of marrow blasts and poor-risk cytogenetics. Although not included in the model, higher ferritin (P=0.007) and beta2-microglobulin (P<0.001) levels were associated with worse prognosis. This allowed the development of a scoring system in which patients could be grouped in three categories: category 1 (n=182, 21%) with a median survival of 80.3 months (95% CI 68-NA); category 2 (n=408, 48%) with a median survival of 26.6 months (95% CI 22-32) and category 3 (n=265, 31%) with a median survival of 14.2 months (95% CI 13-18). In summary, this analysis indicates that it is possible to identify patients with lower risk MDS and poor prognosis who may benefit from early intervention.Keywords
This publication has 12 references indexed in Scilit:
- Lenalidomide in the Myelodysplastic Syndrome with Chromosome 5q DeletionNew England Journal of Medicine, 2006
- Results of a randomized study of 3 schedules of low-dose decitabine in higher-risk myelodysplastic syndrome and chronic myelomonocytic leukemiaBlood, 2006
- Decitabine improves patient outcomes in myelodysplastic syndromesCancer, 2006
- Prognostic Factors and Life Expectancy in Myelodysplastic Syndromes Classified According to WHO Criteria: A Basis for Clinical Decision MakingJournal of Clinical Oncology, 2005
- Long-term outcome of treatment of anemia in MDS with erythropoietin and G-CSFBlood, 2005
- A decision analysis of allogeneic bone marrow transplantation for the myelodysplastic syndromes: delayed transplantation for low-risk myelodysplasia is associated with improved outcomeBlood, 2004
- Contribution of β-2 microglobulin levels to the prognostic stratification of survival in patients with myelodysplastic syndrome (MDS)Blood, 2003
- Randomized Controlled Trial of Azacitidine in Patients With the Myelodysplastic Syndrome: A Study of the Cancer and Leukemia Group BJournal of Clinical Oncology, 2002
- Proportional hazards tests and diagnostics based on weighted residualsBiometrika, 1994
- Proposals for the classification of the myelodysplastic syndromesBritish Journal of Haematology, 1982