title: Dynamic prognostic value of the revised international prognostic scoring system following pretransplant hypomethylating treatment in myelodysplastic syndrome.
abstract: This study aimed to analyze the use of the revised International Prognostic Scoring System (IPSS-R) assessed after hypomethylating treatment (HMT) for patients with myelodysplastic syndrome (MDS) undergoing an allogeneic stem cell transplantation (SCT). Among 115 patients who received pre-SCT HMT, comparison analysis of the prognostic values between the IPSS-R at the time of HMT (IPSS-R@HMT) and at the time of SCT after HMT (IPSS-R@SCT) showed a significantly higher predictive power for overall survival (OS) of the latter. Alteration in IPSS-R risk occurred in 60%, while the patients with 'down-staged' IPSS-R@SCT showed better OS compared with those with 'unchanged' or 'up-staged' risk. On multivariate analysis in all 201 patients, IPSS-R@SCT, monosomal karyotype, treatment failure to pre-SCT treatment, and high hematopoietic cell transplantation-comorbidity index were independently associated with OS. Constructed using these factors, the MDS Transplantation Prognostic Scoring System (MTPSS) identified four risk groups with 4-year OS of 76.4% in low, 61.4% in intermediate-1 and 21.9% in intermediate-2 risk groups, whereas all in the high risk group died within 2 years after SCT (P<0.001). Our study emphasizes the need for further studies aiming to evaluate a transplantation prognostic model such as the MTPSS to make appropriate decisions for transplantation in MDS.
authors.affiliation: Department of Hematology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
authors.forename: S-A
authors.initials: SA
authors.lastname: Yahng
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Y-W
authors.initials: YW
authors.lastname: Jeon
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Hematology, Yeoido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: S-H
authors.initials: SH
authors.lastname: Shin
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: S-E
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Y-S
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: D-Y
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: B-S
authors.initials: BS
authors.lastname: Cho
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: K-S
authors.initials: KS
authors.lastname: Eom
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: C-K
authors.initials: CK
authors.lastname: Min
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: J-W
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: K-H
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: W-S
authors.initials: WS
authors.lastname: Min
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000494:pharmacology / Q000627:therapeutic use; D015897:Comorbidity; D019175:DNA Methylation / Q000187:drug effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D059785:Karyotype; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic