Validation of the revised IPSS at transplant in patients with myelodysplastic syndrome/transformed acute myelogenous leukemia receiving allogeneic stem cell transplantation: a retrospective analysis of the EBMT chronic malignancies working party.

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  • Additional Information
    • Source:
      Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8702459 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5365 (Electronic) Linking ISSN: 02683369 NLM ISO Abbreviation: Bone Marrow Transplant Subsets: MEDLINE
    • Publication Information:
      Publication: <2003->: London : Nature Publishing Group
      Original Publication: Basingstoke, Hampshire : Scientific & Medical Division, Macmillan Press, c1986-
    • Subject Terms:
      Prognosis*; Hematopoietic Stem Cell Transplantation/*methods ; Leukemia, Myeloid, Acute/*diagnosis ; Myelodysplastic Syndromes/*diagnosis; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Databases, Factual ; Disease-Free Survival ; Female ; Hematopoietic Stem Cell Transplantation/mortality ; Humans ; Leukemia, Myeloid, Acute/mortality ; Leukemia, Myeloid, Acute/therapy ; Male ; Middle Aged ; Myelodysplastic Syndromes/mortality ; Myelodysplastic Syndromes/therapy ; Retrospective Studies ; Risk Factors ; Survival Rate ; Transplantation, Homologous ; Young Adult
    • Abstract:
      The International Prognostic Scoring System has been revised (IPSS-R) to predict prognosis of patients with myelodysplastic syndromes at diagnosis. To validate the use of the IPSS-R assessed before transplant rather than at diagnosis we performed a retrospective analysis of the EBMT database. A total of 579 patients had sufficient information available to calculate IPSS-R at transplant. Median overall survival (OS) from transplant was significantly different according to IPSS-R: very low 23.6 months, low 55.0 months, intermediate 19.7 months, high 13.5 months, very high 7.8 months (P<0.001). In a multivariate Cox model the following parameters were significant risk factors for OS: IPSS-R, graft source, age and prior treatment. Median relapse free survival also showed significant differences according to IPSS-R: very low: 23.6 months, low: 24.8 months, intermediate 10.6 months, high 7.9 months, very high 5.5 months (P<0.001). Multivariate risk factors for relapse-free survival (RFS) were: IPSS-R, reduced intensity conditioning, graft source and prior treatment. A trend for an increased relapse incidence was noted for very high risk IPSS-R. We conclude that the IPSS-R at transplant is a useful prognostic score for predicting OS and RFS after transplantation, capturing both disease evolution and response to prior treatment before transplant.
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    • Publication Date:
      Date Created: 20170912 Date Completed: 20180625 Latest Revision: 20191210
    • Publication Date:
      20221213
    • Accession Number:
      PMC5671928
    • Accession Number:
      10.1038/bmt.2017.171
    • Accession Number:
      28892084