TY - JOUR
T1 - Prognosis of patients with intermediate risk IPSS-R myelodysplastic syndrome indicates variable outcomes and need for models beyond IPSS-R
AU - Benton, Christopher B.
AU - Khan, Maliha
AU - Sallman, David
AU - Nazha, Aziz
AU - Nogueras González, Graciela M.
AU - Piao, Jin
AU - Ning, Jing
AU - Aung, Fleur
AU - Al Ali, Najla
AU - Jabbour, Elias
AU - Kadia, Tapan M.
AU - Borthakur, Gautam
AU - Ravandi, Farhad
AU - Pierce, Sherry
AU - Steensma, David
AU - DeZern, Amy
AU - Roboz, Gail
AU - Sekeres, Mikkael
AU - Andreeff, Michael
AU - Kantarjian, Hagop
AU - Komrokji, Rami S.
AU - Garcia-Manero, Guillermo
N1 - Funding Information:
MD Anderson Moon Shot; MDS Clinical Research Consortium, Grant/Award Number: Edwards P. Evans Foundation; NIH/NCI Cancer Center Support Grant, Grant/Award Number: P30 CA016672
Funding Information:
information MD Anderson Moon Shot; MDS Clinical Research Consortium, Grant/Award Number: Edwards P. Evans Foundation; NIH/NCI Cancer Center Support Grant, Grant/Award Number: P30 CA016672This work was supported by the Cancer Center Support Grant from the NIH/NCI, P30 CA016672, the MDS Clinical Research Consortium funded by the Edwards P. Evans Foundation, and by generous philanthropic contributions to MD Anderson's Moon Shot Program.
Funding Information:
This work was supported by the Cancer Center Support Grant from the NIH/NCI, P30 CA016672, the MDS Clinical Research Consortium funded by the Edwards P. Evans Foundation, and by generous philanthropic contributions to MD Anderson's Moon Shot Program.
Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/10
Y1 - 2018/10
N2 - The International Prognostic Scoring System-Revised (IPSS-R) is one standard for myelodysplastic syndrome (MDS) risk stratification. It divides patients into five categories including an intermediate subset (IPSS-R int-risk). Outcomes and clinical interventions for patients with IPSS-R int-risk are not well defined. We performed an analysis of outcomes of this group of patients. Out of 3167 patients, a total of 298 were identified with IPSS-R int-risk MDS and retrospectively analyzed to assess characteristics affecting outcomes. Cox proportional hazard models for overall survival (OS) were performed to identify statistically significant clinical factors that influence survival. Age of 66 years or greater, peripheral blood blasts of 2% or more, and history of red blood cell (RBC) transfusion were significantly associated with inferior survival. Based on these features, MDS patients with IPSS-R int-risk were classified into two prognostic risk groups for analysis, an int-favorable group and an int-adverse group, and had significantly divergent outcomes. Sequential prognostication was validated using two independent datasets comprising over 700 IPSS-R int-risk patients. The difference in median survival between int-favorable and int-adverse patients was 3.7 years in the test cohort, and 1.8 and 2.0 years in the two validation cohorts. These results confirm significantly variable outcomes of patients with IPSS-R int-risk and need for different prognostic systems.
AB - The International Prognostic Scoring System-Revised (IPSS-R) is one standard for myelodysplastic syndrome (MDS) risk stratification. It divides patients into five categories including an intermediate subset (IPSS-R int-risk). Outcomes and clinical interventions for patients with IPSS-R int-risk are not well defined. We performed an analysis of outcomes of this group of patients. Out of 3167 patients, a total of 298 were identified with IPSS-R int-risk MDS and retrospectively analyzed to assess characteristics affecting outcomes. Cox proportional hazard models for overall survival (OS) were performed to identify statistically significant clinical factors that influence survival. Age of 66 years or greater, peripheral blood blasts of 2% or more, and history of red blood cell (RBC) transfusion were significantly associated with inferior survival. Based on these features, MDS patients with IPSS-R int-risk were classified into two prognostic risk groups for analysis, an int-favorable group and an int-adverse group, and had significantly divergent outcomes. Sequential prognostication was validated using two independent datasets comprising over 700 IPSS-R int-risk patients. The difference in median survival between int-favorable and int-adverse patients was 3.7 years in the test cohort, and 1.8 and 2.0 years in the two validation cohorts. These results confirm significantly variable outcomes of patients with IPSS-R int-risk and need for different prognostic systems.
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U2 - 10.1002/ajh.25234
DO - 10.1002/ajh.25234
M3 - Article
C2 - 30051599
AN - SCOPUS:85053842937
SN - 0361-8609
VL - 93
SP - 1245
EP - 1253
JO - American journal of hematology
JF - American journal of hematology
IS - 10
ER -