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| Leukemia. 2015 Feb 27. pii: leu201555. doi: 10.1038/leu.2015.55 |
| Validation of WHO classification-based Prognostic Scoring System (WPSS) for myelodysplastic syndromes and comparison with the revised International Prognostic Scoring System (IPSS-R). A study of the International Working Group for Prognosis in Myelodysplasia (IWG-PM). |
| Della Porta MG1, Tuechler H2, Malcovati L3, Schanz J4, Sanz G5, Garcia-Manero G6, Solé F7, Bennett JM8, Bowen D9, Fenaux P10, Dreyfus F11, Kantarjian H12, Kuendgen A13, Levis A14, Cermak J15, Fonatsch C16, Le Beau MM17, Slovak ML18, Krieger O19, Luebbert M20, Maciejewski J21, Magalhaes SM22, Miyazaki Y23, Pfeilstöcker M24, Sekeres MA25, Sperr WR26, Stauder R27, Tauro S28, Valent P29, Vallespi T30, van de Loosdrecht AA31, Germing U32, Haase D33, Greenberg PL34, Cazzola M35 |
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Abstract A risk-adapted treatment strategy is mandatory for myelodysplastic syndromes (MDS). We refined the World Health Organization (WHO)-classification-based Prognostic Scoring System (WPSS) by determining the impact of the newer clinical and cytogenetic features, and we compared its prognostic power to that of the revised International Prognostic Scoring System (IPSS-R). A population of 5326 untreated MDS was considered. We analyzed single WPSS parameters and confirmed that the WHO classification and severe anemia provide important prognostic information in MDS. A strong correlation was found between the WPSS including the new cytogenetic risk stratification and WPSS adopting original criteria. We then compared WPSS with the IPSS-R prognostic system. A highly significant correlation was found between the WPSS and IPSS-R risk classifications. Discrepancies did occur among lower-risk patients in whom the number of dysplastic hematopoietic lineages as assessed by morphology did not reflect the severity of peripheral blood cytopenias and/or increased marrow blast count. Moreover, severe anemia has higher prognostic weight in the WPSS versus IPSS-R model. Overall, both systems well represent the prognostic risk of MDS patients defined by WHO morphologic criteria. This study provides relevant in formation for the implementation of risk-adapted strategies in MDS. |
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Publikations ID: 25721895 Quelle: öffnen |
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