title: WPSS is a strong prognostic indicator for clinical outcome of allogeneic transplant for myelodysplastic syndrome in Southeast Asian patients.
abstract: To better understand the predictive factors and improve clinical outcome of allogeneic transplant for patients with myelodysplastic syndrome (MDS), we retrospectively analyzed the post-transplant outcome of 60 Southeast Asian patients with MDS. Multivariate analysis showed that WHO classification-based Prognostic Scoring System (WPSS) significantly affect overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), and cumulative incidence of non-relapse mortality (CINRM). Stratified by WPSS into very low/low, intermediate, high, and very high-risk categories, 3-year OS was 100, 61, 37, and 18% (p = 0.02); PFS was 100, 55, 32, and 18% (p = 0.014); CIR was 12, 24, 38, and 59% (p = 0.024); CINRM was 0, 6, 12, and 26% (p = 0.037), respectively. WHO classification, Revised International Prognostic Scoring System (IPSS-R), IPSS-R-defined cytogenetic risk groups, donor gender, and acute and chronic graft vs host disease (GVHD) also influenced different aspects of transplant outcome. We found that WPSS is a powerful predictor of post-transplant outcome. WPSS provides an important model not only for prognostication but also for exploration of further post-transplant measures such as immunological maneuvers or novel therapy to improve the poor outcome of high-risk patients.
authors.affiliation: Division of Hematology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Liyuan
authors.initials: L
authors.lastname: Ma
authors.forename: Siguo
authors.initials: S
authors.lastname: Hao
authors.forename: Colin
authors.initials: C
authors.lastname: Diong
authors.forename: Yeow-Tee
authors.initials: YT
authors.lastname: Goh
authors.forename: Sathish
authors.initials: S
authors.lastname: Gopalakrishnan
authors.forename: Aloysius
authors.initials: A
authors.lastname: Ho
authors.forename: William
authors.initials: W
authors.lastname: Hwang
authors.forename: Liang-Piu
authors.initials: LP
authors.lastname: Koh
authors.forename: Mickey
authors.initials: M
authors.lastname: Koh
authors.forename: Zi-Yi
authors.initials: ZY
authors.lastname: Lim
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Loh
authors.forename: Michelle
authors.initials: M
authors.lastname: Poon
authors.forename: Lip-Kun
authors.initials: LK
authors.lastname: Tan
authors.forename: Patrick
authors.initials: P
authors.lastname: Tan
authors.forename: Yeh-Ching
authors.initials: YC
authors.lastname: Linn
mesh_terms: D001210:Asia, Southeastern; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome