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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Am+J+Hematol
2013 ; 88
(7
): 566-70
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Validation of the revised International Prognostic Scoring System in treated
patients with myelodysplastic syndromes
#MMPMID23605934
Mishra A
; Corrales-Yepez M
; Ali NA
; Kharfan-Dabaja M
; Padron E
; Zhang L
; Epling-Burnette PK
; Pinilla-Ibarz J
; Lancet JE
; List AF
; Komrokji RS
Am J Hematol
2013[Jul]; 88
(7
): 566-70
PMID23605934
show ga
The International Prognostic Scoring System (IPSS) was recently revised (IPSS-R)
under the auspices of the MDS Foundation as a collaborative international effort
to refine its prognostic power. Our purpose was to externally validate this new
risk model using a large single-institution cohort, determine its prognostic
power in patients receiving active treatment, and explore its utility in guiding
therapeutic decisions. Data were collected retrospectively from our
myelodysplastic syndrome (MDS) database and verified by chart review. Of the data
available for 1,088 patients, 152 (14%), 353 (32%), 237 (22%), 190 (18%), and 156
(14%) patients were classified as very low, low, intermediate, high, and very
high risk, respectively, with median overall survival (OS) of 90 (95%CI 71-109),
54 (95%CI 50-59), 34 (95%CI 26-43), 21 (95%CI 17-25), and 13 months (95%CI
11-15), respectively (P?0.005). We found that the IPSS-R further refined
prognostic discrimination in all IPSS risk categories, particularly in the
intermediate 1 and 2 groups. Among high and very high IPSS-R patients receiving
azacitidine, OS was significantly improved versus patients not receiving
azacitidine, with corresponding median OS of 25 versus 18 months (P?=?0.028) and
15 versus 9 months (P?=?0.005), respectively. Similarly, patients with IPSS-R
high- and very high-risk disease who underwent allogeneic hematopoietic stem cell
transplantation had significantly improved OS versus nontransplant approaches
(P?0.005). High and very high IPSS-R patients derived a survival advantage from
disease-modifying therapies. Our data validate the prognostic value of the
proposed IPSS-R and show that its refined IPSS prognostic discrimination can be
applied to actively treated patients.
|*Hematopoietic Stem Cell Transplantation
[MESH]
|Antimetabolites, Antineoplastic/*therapeutic use
[MESH]