Revised International Prognostic Scoring System for Myelodysplastic Syndromes

被引：2467

作者：

Greenberg, Peter L. ^{[1
]}

Tuechler, Heinz ^{[2
]}

Schanz, Julie ^{[3
]}

Sanz, Guillermo ^{[4
]}

Garcia-Manero, Guillermo ^{[5
]}

Sole, Francesc ^{[6
]}

Bennett, John M. ^{[7
]}

Bowen, David ^{[8
]}

Fenaux, Pierre ^{[9
]}

Dreyfus, Francois ^{[10
]}

Kantarjian, Hagop ^{[5
]}

Kuendgen, Andrea ^{[11
]}

Levis, Alessandro ^{[12
]}

Malcovati, Luca ^{[13
,14
]}

Cazzola, Mario ^{[13
,14
]}

Cermak, Jaroslav ^{[15
]}

Fonatsch, Christa ^{[16
]}

Le Beau, Michelle M. ^{[17
]}

Slovak, Marilyn L. ^{[18
]}

Krieger, Otto ^{[19
]}

Luebbert, Michael ^{[20
]}

Maciejewski, Jaroslaw ^{[21
]}

Magalhaes, Silvia M. M. ^{[22
]}

Miyazaki, Yasushi ^{[23
]}

Pfeilstoecker, Michael ^{[2
]}

Sekeres, Mikkael ^{[21
]}

Sperr, Wolfgang R. ^{[16
]}

Stauder, Reinhard ^{[24
]}

Tauro, Sudhir ^{[25
]}

Valent, Peter ^{[16
]}

Vallespi, Teresa ^{[26
]}

van de Loosdrecht, Arjan A. ^{[27
]}

Germing, Ulrich ^{[11
]}

Haase, Detlef ^{[3
]}

机构：

[1] Stanford Univ, Ctr Canc, Div Hematol, Stanford, CA 94305 USA

[2] Hanusch Hosp, Boltzmann Inst Leukemia Res, Vienna, Austria

[3] Univ Gottingen, Gottingen, Germany

[4] Hosp Univ La Fe, Valencia, Spain

[5] Univ Texas Houston, MD Anderson Canc Ctr, Houston, TX 77030 USA

[6] Hosp del Mar, Barcelona, Spain

[7] Univ Rochester, Med Ctr, James P Wilmont Canc Ctr, Rochester, NY 14642 USA

[8] St James Univ Hosp, Leeds, W Yorkshire, England

[9] Univ Paris 13, Hop Avicenne, AP HP, Bobigny, France

[10] Univ Paris 05, Hop Cochin, AP HP, Paris, France

[11] Heinrich Heine Univ Hosp, Dusseldorf, Germany

[12] Antonio & Biagio & C Arrigo Hosp, Alessandria, Italy

[13] Sci Policlin San Matteo, Fdn Ist Ricovero & Cura Carattere, Pavia, Italy

[14] Univ Pavia, I-27100 Pavia, Italy

[15] Inst Hematol & Blood Transfus, CR-12820 Prague, Czech Republic

[16] Med Univ Vienna, Vienna, Austria

[17] Univ Chicago, Comprehens Canc Res Ctr, Chicago, IL 60637 USA

[18] Quest Diagnost Nichols Inst, Chantilly, VA USA

[19] Elisabethinen Hosp, Linz, Austria

[20] Univ Freiburg, Med Ctr, Freiburg, Germany

[21] Cleveland Clin, Cleveland, OH 44106 USA

[22] Univ Fed Ceara, Fortaleza, Ceara, Brazil

[23] Nagasaki Univ, Grad Sch Biomed Sci, Nagasaki, Japan

[24] Univ Innsbruck Hosp, A-6020 Innsbruck, Austria

[25] Univ Dundee, Dundee DD1 4HN, Scotland

[26] Hosp Univ Vall dHebron, Barcelona, Spain

[27] Vrije Univ Amsterdam, Med Ctr, Amsterdam, Netherlands

来源：

BLOOD | 2012年 / 120卷 / 12期

关键词：

ACUTE MYELOID-LEUKEMIA; PREDICTING SURVIVAL; MARROW FIBROSIS; FLOW-CYTOMETRY; SYNDROMES MDS; RISK; IMPACT; CLASSIFICATION; COMORBIDITY; RELEVANCE;

D O I：

10.1182/blood-2012-03-420489

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The International Prognostic Scoring Sytem (IPSS) is an important standard for ssessing prognosis of primary untreated adult patients with myelodysplastic syndromes (MDS). To refine the IPSS, MDS patient databases from international institutions were coalesced to assemble a much larger combined database (Revised-IPSS [IPSS-R], n = 7012, IPSS, n = 816) for analysis. Multiple statistically weighted clinical features were used to generate a prognostic categorization model. Bone marrow cytogenetics, marrow blast percentage, and cytopenias remained the basis of the new system. Novel components of the current analysis included: 5 rather than 3 cytogenetic prognostic subgroups with specific and new classifications of a number of less common cytogenetic subsets, splitting the low marrow blast percentage value, and depth of cytopenias. This model defined 5 rather than the 4 major prognostic categories that are present in the IPSS. Patient age, performance status, serum ferritin, and lactate dehydrogenase were significant additive features for survival but not for acute myeloid leukemia transformation. This system comprehensively integrated the numerous known clinical features into a method analyzing MDS patient prognosis more precisely than the initial IPSS. As such, this IPSS-R should prove beneficial for predicting the clinical outcomes of untreated MDS patients and aiding design and analysis of clinical trials in this disease. (Blood. 2012;120(12):2454-2465)

引用

页码：2454 / 2465

页数：12

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