title: Prognostic impact of age and gender in 897 untreated patients with primary myelodysplastic syndromes.
abstract: BACKGROUND
  The International Prognostic Scoring System (IPSS) is the golden standard to assess prognosis in myelodysplastic syndromes (MDS). The aim of this analysis was to study age and gender as interacting variables for individualized prognostication.
  
  
  METHODS
  In all, 897 patients with primary MDS treated with supportive care only were examined in a retrospective multicenter study. A Cox model was developed to determine the prognostic impact of age and gender on survival and to examine their modulating influence on IPSS results. Based on main effects and interactions of these variables, we established an individualized age- and gender-adapted scoring system to improve prognostication in MDS.
  
  
  RESULTS
  While the risk of a patient in the IPSS is best represented by the values 0 (low), +1 (intermediate-1), +2 (intermediate-2), and +3 (high), these values were found to vary between -1.9 and +3.5 in the same patients when including age and gender. Whereas in low-risk MDS, male patients were found to have a less favorable survival, a particularly high risk (+3.5) was found in younger (< or = 66 years) high-risk female patients.
  
  
  CONCLUSIONS
  The inclusion of age and gender and their respective interactions contribute to improved and individualized prognostication in MDS.
authors: Third Medical Department for Hematology and Oncology, Hanusch Hospital, Vienna, Austria.
authors: T
authors: T
authors: Nösslinger
authors: H
authors: H
authors: Tüchler
authors: U
authors: U
authors: Germing
authors: W R
authors: WR
authors: Sperr
authors: O
authors: O
authors: Krieger
authors: D
authors: D
authors: Haase
authors: M
authors: M
authors: Lübbert
authors: R
authors: R
authors: Stauder
authors: A
authors: A
authors: Giagounidis
authors: P
authors: P
authors: Valent
authors: M
authors: M
authors: Pfeilstöcker
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult