title: Contribution of Revised International Prognostic Scoring System Cytogenetics to Predict Outcome After Allogeneic Stem Cell Transplantation for Myelodysplastic Syndromes: A Study From the French Society of Bone Marrow Transplantation and Cellular Therapy.
abstract: BACKGROUND
  The prognosis of myelodysplastic syndromes (MDS) after allogeneic stem cell transplantation is critically determined by cytogenetic abnormalities, as previously defined by International Prognostic Scoring System (IPSS) cytogenetics. It has been shown that a new cytogenetic classification, included in the IPSS-R (cytogenetic-IPSS-R [C-IPSS-R]), can better predict the outcome of untreated MDS patients.
  
  
  METHODS
  In this study, we assessed the impact of the IPSS-R cytogenetic score (C-IPSS-R) on the outcome of 367 MDS patients transplanted from HLA-identical siblings or HLA allele-matched unrelated donors.
  
  
  RESULTS
  According to the C-IPSS-R, 178 patients (48%) fell in the good risk, 102 (28%) in the intermediate risk, 77 (21%) in the poor risk, and 10 (3%) in the very poor risk group. In multivariate analysis, after a median follow-up of 4 years, the poor and very poor-risk categories correlated with shorter overall survival (OS) (4-year OS, 32%; hazard ratio [HR], 1.59; P = 0.009 and OS, 10%; HR, 3.18; P = 0.002, respectively) and higher cumulative incidence of relapse (CIR) (CIR, 52%; HR, 1.82; P = 0.004 and CIR, 60%; HR, 2.44; P = 0.060, respectively).
  
  
  CONCLUSIONS
  Overall, the C-IPSS-R changed the IPSS cytogenetic risk only in 8% of cases but identified a new risk group, the very poor C-IPSS-R category, with dismal outcome after allogeneic stem cell transplantation (10% 4-year OS, 60% 4-year CIR). Posttransplantation maintenance therapy should be investigated in prospective trials for patients with high-risk C-IPSS-R karyotypes.
authors.affiliation: 1 CHRU Lille, Pôle Spécialités Médicales et Gérontologie, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, F59037, Lille, France. 2 Université de Lille, UFR Médecine F59000, Lille, France. 3 Hematology Department, Caen University Hospital, Amiens, France. 4 Department of Biostatistics, Lille University Hospital, Lille, France. 5 Hematology Department and Hematopoietic Stem Cell Transplantation Unit, Saint-Louis Hospital, Paris, France. 6 Hematology Department, Lyon-Sud Hospital, Lyon, France. 7 Hematology Department, Nantes, France. 8 Hematology Department CH-Liège, Liège, Belgium. 9 Hematology Department, Pitié-Salpêtrière Hospital, Paris, France. 10 Hematology Department, Strasbourg University Hospital, Strasbourg, France. 11 Hematopoietic Stem Cell Transplantation Unit, Paoli Calmettes Institute, Marseille, France. 12 Hematology Department, Loire Oncology Institute (ICL), Saint Priest en Jarez, France. 13 Hematology Department, Nantes University Hospital, Nantes, France. 14 Hematology Department, Saint-Antoine Hospital, Paris, France. 15 Hematology Department, Toulouse University Hospital, Toulouse, France. 16 Hematology Department, Grenoble University Hospital, Grenoble, France. 17 Hematology Department, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Jordan
authors.initials: J
authors.lastname: Gauthier
authors.forename: Gandhi
authors.initials: G
authors.lastname: Damaj
authors.forename: Carole
authors.initials: C
authors.lastname: Langlois
authors.forename: Marie
authors.initials: M
authors.lastname: Robin
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Patrice
authors.initials: P
authors.lastname: Chevallier
authors.forename: Yves
authors.initials: Y
authors.lastname: Beguin
authors.forename: Stéphanie
authors.initials: S
authors.lastname: N'guyen
authors.forename: Pierre
authors.initials: P
authors.lastname: Bories
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.forename: Jérôme
authors.initials: J
authors.lastname: Cornillon
authors.forename: Aline
authors.initials: A
authors.lastname: Clavert
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Anne
authors.initials: A
authors.lastname: Huynh
authors.forename: Anne
authors.initials: A
authors.lastname: Thiébaut-Bertrand
authors.forename: Stéphane
authors.initials: S
authors.lastname: Vigouroux
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
mesh_terms: D001530:Belgium; D020732:Cytogenetic Analysis; D003661:Decision Support Techniques; D005260:Female; D005602:France; D006680:HLA Antigens / Q000235:genetics* / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D053208:Kaplan-Meier Estimate; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000235:genetics* / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D035781:Siblings; D012955:Societies, Medical; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D061349:Unrelated Donors
chemical_list: D006680:HLA Antigens