title: New comprehensive cytogenetic scoring system for primary myelodysplastic syndromes (MDS) and oligoblastic acute myeloid leukemia after MDS derived from an international database merge.
abstract: OBJECTIVE
  The karyotype is a strong independent prognostic factor in myelodysplastic syndromes (MDS). Since the implementation of the International Prognostic Scoring System (IPSS) in 1997, knowledge concerning the prognostic impact of abnormalities has increased substantially. The present study proposes a new and comprehensive cytogenetic scoring system based on an international data collection of 2,902 patients.
  
  
  METHODS
  Patients were included from the German-Austrian MDS Study Group (n = 1,193), the International MDS Risk Analysis Workshop (n = 816), the Spanish Hematological Cytogenetics Working Group (n = 849), and the International Working Group on MDS Cytogenetics (n = 44) databases. Patients with primary MDS and oligoblastic acute myeloid leukemia (AML) after MDS treated with supportive care only were evaluated for overall survival (OS) and AML evolution. Internal validation by bootstrap analysis and external validation in an independent patient cohort were performed to confirm the results.
  
  
  RESULTS
  In total, 19 cytogenetic categories were defined, providing clear prognostic classification in 91% of all patients. The abnormalities were classified into five prognostic subgroups (P < .001): very good (median OS, 61 months; hazard ratio [HR], 0.5; n = 81); good (49 months; HR, 1.0 [reference category]; n = 1,809); intermediate (26 months; HR, 1.6; n = 529); poor (16 months; HR, 2.6; n = 148); and very poor (6 months; HR, 4.2; n = 187). The internal and external validations confirmed the results of the score.
  
  
  CONCLUSIONS
  In conclusion, these data should contribute to the ongoing efforts to update the IPSS by refining the cytogenetic risk categories.
authors.affiliation: University of Göttingen, Göttingen, Germany.
authors.forename: Julie
authors.initials: J
authors.lastname: Schanz
authors.forename: Heinz
authors.initials: H
authors.lastname: Tüchler
authors.forename: Francesc
authors.initials: F
authors.lastname: Solé
authors.forename: Mar
authors.initials: M
authors.lastname: Mallo
authors.forename: Elisa
authors.initials: E
authors.lastname: Luño
authors.forename: José
authors.initials: J
authors.lastname: Cervera
authors.forename: Isabel
authors.initials: I
authors.lastname: Granada
authors.forename: Barbara
authors.initials: B
authors.lastname: Hildebrandt
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Slovak
authors.forename: Kazuma
authors.initials: K
authors.lastname: Ohyashiki
authors.forename: Christian
authors.initials: C
authors.lastname: Steidl
authors.forename: Christa
authors.initials: C
authors.lastname: Fonatsch
authors.forename: Michael
authors.initials: M
authors.lastname: Pfeilstöcker
authors.forename: Thomas
authors.initials: T
authors.lastname: Nösslinger
authors.forename: Peter
authors.initials: P
authors.lastname: Valent
authors.forename: Aristoteles
authors.initials: A
authors.lastname: Giagounidis
authors.forename: Carlo
authors.initials: C
authors.lastname: Aul
authors.forename: Michael
authors.initials: M
authors.lastname: Lübbert
authors.forename: Reinhard
authors.initials: R
authors.lastname: Stauder
authors.forename: Otto
authors.initials: O
authors.lastname: Krieger
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Le Beau
authors.forename: John M
authors.initials: JM
authors.lastname: Bennett
authors.forename: Peter
authors.initials: P
authors.lastname: Greenberg
authors.forename: Ulrich
authors.initials: U
authors.lastname: Germing
authors.forename: Detlef
authors.initials: D
authors.lastname: Haase
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D002869:Chromosome Aberrations; D030541:Databases, Genetic; D005260:Female; D006801:Humans; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000209:etiology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000235:genetics* / Q000401:mortality; D011379:Prognosis