title: Revised international prognostic scoring system for myelodysplastic syndromes.
abstract: The International Prognostic Scoring System (IPSS) is an important standard for assessing prognosis of primary untreated adult patients with myelodysplastic syndromes (MDS). To refine the IPSS, MDS patient databases from international institutions were coalesced to assemble a much larger combined database (Revised-IPSS [IPSS-R], n = 7012, IPSS, n = 816) for analysis. Multiple statistically weighted clinical features were used to generate a prognostic categorization model. Bone marrow cytogenetics, marrow blast percentage, and cytopenias remained the basis of the new system. Novel components of the current analysis included: 5 rather than 3 cytogenetic prognostic subgroups with specific and new classifications of a number of less common cytogenetic subsets, splitting the low marrow blast percentage value, and depth of cytopenias. This model defined 5 rather than the 4 major prognostic categories that are present in the IPSS. Patient age, performance status, serum ferritin, and lactate dehydrogenase were significant additive features for survival but not for acute myeloid leukemia transformation. This system comprehensively integrated the numerous known clinical features into a method analyzing MDS patient prognosis more precisely than the initial IPSS. As such, this IPSS-R should prove beneficial for predicting the clinical outcomes of untreated MDS patients and aiding design and analysis of clinical trials in this disease.
authors: Hematology Division, Stanford University Cancer Center, Stanford, CA 94305, USA. peterg@stanford.edu
authors: Peter L
authors: PL
authors: Greenberg
authors: Heinz
authors: H
authors: Tuechler
authors: Julie
authors: J
authors: Schanz
authors: Guillermo
authors: G
authors: Sanz
authors: Guillermo
authors: G
authors: Garcia-Manero
authors: Francesc
authors: F
authors: Solé
authors: John M
authors: JM
authors: Bennett
authors: David
authors: D
authors: Bowen
authors: Pierre
authors: P
authors: Fenaux
authors: Francois
authors: F
authors: Dreyfus
authors: Hagop
authors: H
authors: Kantarjian
authors: Andrea
authors: A
authors: Kuendgen
authors: Alessandro
authors: A
authors: Levis
authors: Luca
authors: L
authors: Malcovati
authors: Mario
authors: M
authors: Cazzola
authors: Jaroslav
authors: J
authors: Cermak
authors: Christa
authors: C
authors: Fonatsch
authors: Michelle M
authors: MM
authors: Le Beau
authors: Marilyn L
authors: ML
authors: Slovak
authors: Otto
authors: O
authors: Krieger
authors: Michael
authors: M
authors: Luebbert
authors: Jaroslaw
authors: J
authors: Maciejewski
authors: Silvia M M
authors: SM
authors: Magalhaes
authors: Yasushi
authors: Y
authors: Miyazaki
authors: Michael
authors: M
authors: Pfeilstöcker
authors: Mikkael
authors: M
authors: Sekeres
authors: Wolfgang R
authors: WR
authors: Sperr
authors: Reinhard
authors: R
authors: Stauder
authors: Sudhir
authors: S
authors: Tauro
authors: Peter
authors: P
authors: Valent
authors: Teresa
authors: T
authors: Vallespi
authors: Arjan A
authors: AA
authors: van de Loosdrecht
authors: Ulrich
authors: U
authors: Germing
authors: Detlef
authors: D
authors: Haase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology*; D002869:Chromosome Aberrations; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D007390:International Agencies; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification* / Q000401:mortality* / Q000473:pathology; D010198:Pancytopenia / Q000175:diagnosis* / Q000401:mortality*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate