title: Validation of the Revised International Prognostic Scoring System for patients with myelodysplastic syndromes.
abstract: The objective of this study is to externally validate the recently published Revised International Prognostic Scoring System (IPSS-R) for myelodysplastic syndrome (MDS) and compare it with the International Prognostic Scoring System (IPSS). We conducted a retrospective study of 173 adult MDS patients who had not received disease-altering treatment. Using the Cox hazard method, we found the IPSS-R to be a significant predictor of survival (p < 0.001, hazard ratio, HR = 1.82, 95% confidence interval, CI 1.57-2.12) and time to acute myeloid leukemia (AML; p < 0.001, HR = 2.05, 95% CI 1.55-2.70). The IPSS-R has greater prognostic power for survival and time to AML compared with the IPSS, given higher Somers' D values (0.41 vs. 0.39 and 0.55 vs. 0.53, respectively). Using the log-rank test, we found a significant difference when comparing IPSS-R groups (p < 0.02), with the exception of the high-risk versus very high-risk group comparison. The IPSS-R reclassified low-risk and intermediate-1 IPSS groups into four groups (log-rank, p < 0.001) and intermediate-2 and high-risk IPSS groups into three groups (log-rank, p < 0.04, excluding high-risk vs. very high-risk comparison). We conclude that the IPSS-R has significant prognostic utility for MDS patients.
authors: Clinic of Hematology, Clinical Center of Vojvodina, University of Novi Sad, Novi Sad, Serbia.
authors: Aleksandar
authors: A
authors: Savic
authors: Dragomir
authors: D
authors: Marisavljevic
authors: Vanja
authors: V
authors: Kvrgic
authors: Natasa
authors: N
authors: Stanisavljevic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic; D005500:Follow-Up Studies; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology / Q000209:etiology; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D055771:Serbia / Q000453:epidemiology; D012720:Severity of Illness Index; D016019:Survival Analysis