title: Validation of WHO classification-based Prognostic Scoring System (WPSS) for myelodysplastic syndromes and comparison with the revised International Prognostic Scoring System (IPSS-R). A study of the International Working Group for Prognosis in Myelodysplasia (IWG-PM).
abstract: A risk-adapted treatment strategy is mandatory for myelodysplastic syndromes (MDS). We refined the World Health Organization (WHO)-classification-based Prognostic Scoring System (WPSS) by determining the impact of the newer clinical and cytogenetic features, and we compared its prognostic power to that of the revised International Prognostic Scoring System (IPSS-R). A population of 5326 untreated MDS was considered. We analyzed single WPSS parameters and confirmed that the WHO classification and severe anemia provide important prognostic information in MDS. A strong correlation was found between the WPSS including the new cytogenetic risk stratification and WPSS adopting original criteria. We then compared WPSS with the IPSS-R prognostic system. A highly significant correlation was found between the WPSS and IPSS-R risk classifications. Discrepancies did occur among lower-risk patients in whom the number of dysplastic hematopoietic lineages as assessed by morphology did not reflect the severity of peripheral blood cytopenias and/or increased marrow blast count. Moreover, severe anemia has higher prognostic weight in the WPSS versus IPSS-R model. Overall, both systems well represent the prognostic risk of MDS patients defined by WHO morphologic criteria. This study provides relevant in formation for the implementation of risk-adapted strategies in MDS.
authors.affiliation: 1] Department of Hematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy [2] Department of Internal Medicine, University of Pavia, Pavia, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Della Porta
authors.affiliation: Hanusch Hospital, Boltzmann Institute for Leukemia Research, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Tuechler
authors.affiliation: 1] Department of Hematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy [2] Department of Molecular Medicine, University of Pavia, Pavia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Malcovati
authors.affiliation: Georg August Universität, Göttingen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schanz
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Sanz
authors.affiliation: The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: G
authors.initials: G
authors.lastname: Garcia-Manero
authors.affiliation: Institut de Recerca contra la Leucèmia Josep Carreras, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Solé
authors.affiliation: James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Bennett
authors.affiliation: St James's University Hospital, Leeds, UK.
authors.forename: D
authors.initials: D
authors.lastname: Bowen
authors.affiliation: Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP)/University Paris XIII, Bobigny, France.
authors.forename: P
authors.initials: P
authors.lastname: Fenaux
authors.affiliation: Hôpital Cochin, AP-HP University of Paris V, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Dreyfus
authors.affiliation: The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: H
authors.initials: H
authors.lastname: Kantarjian
authors.affiliation: Heinrich-Heine University Hospital, Düsseldorf, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kuendgen
authors.affiliation: Fondazione Italiana Sindromi Mielodisplastiche c/o SS Antonio e Biagio Hospital, Alessandria, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Levis
authors.affiliation: Institute of Hematology and Blood Transfusion, Praha, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Cermak
authors.affiliation: Medical University of Vienna, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Fonatsch
authors.affiliation: University of Chicago Comprehensive Cancer Research Center, Chicago, IL, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Le Beau
authors.affiliation: Quest Diagnostics Nichols Institute, Chantilly, VA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Slovak
authors.affiliation: Elisabethinen Hospital, Linz, Austria.
authors.forename: O
authors.initials: O
authors.lastname: Krieger
authors.affiliation: University of Freiburg Medical Center, Freiburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Luebbert
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: J
authors.initials: J
authors.lastname: Maciejewski
authors.affiliation: Federal University of Ceara, Fortaleza, Brazil.
authors.forename: S M M
authors.initials: SM
authors.lastname: Magalhaes
authors.affiliation: Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Hanusch Hospital and L. Boltzmann Cluster Oncology, Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Pfeilstöcker
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Sekeres
authors.affiliation: Medical University of Vienna, Vienna, Austria.
authors.forename: W R
authors.initials: WR
authors.lastname: Sperr
authors.affiliation: Hanusch Hospital and L. Boltzmann Cluster Oncology, Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Stauder
authors.affiliation: University of Dundee, Dundee, Scotland, UK.
authors.forename: S
authors.initials: S
authors.lastname: Tauro
authors.affiliation: Medical University of Vienna, Vienna, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Valent
authors.affiliation: Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Vallespi
authors.affiliation: Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: A A
authors.initials: AA
authors.lastname: van de Loosdrecht
authors.affiliation: Heinrich-Heine University Hospital, Düsseldorf, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Germing
authors.affiliation: Georg August Universität, Göttingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Haase
authors.affiliation: Division of Hematology, Stanford University Cancer Center, Stanford, CA, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: Greenberg
authors.affiliation: 1] Department of Hematology Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy [2] Department of Molecular Medicine, University of Pavia, Pavia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cazzola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D020732:Cytogenetic Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification* / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012107:Research Design; D018570:Risk Assessment; D015996:Survival Rate; D014944:World Health Organization; D055815:Young Adult