Application of the revised International Prognostic Scoring System for Myelodysplastic Syndromes in Argentinean patients

BELLI, CAROLINA; BESTACH, YESICA; GIUNTA, MARIO; IASTREBNER, MARCELO; SANTOS, ISABEL; PINTOS, NOEMÍ; ARBELBIDE, JORGE; BASQUIERA, ANA L; BENGIÓ, RAQUEL; LARRIPA, IRENE

ANNALS OF HEMATOLOGY

SPRINGER

Lugar: Berlin; Año: 2014 vol. 54 p. 705 - 707

0939-5555

The International Prognostic Scoring System (IPSS) [1], the gold standard for risk assessment in Myelodysplastic syndromes (MDS), has been recently revised (IPSS-R). The authors proposed a new prognostic model including novel components: five cytogenetic prognostic subgroups with specific classification of a number of less common cytogenetic subsets [2-3]; the 2-150, 131, 51, 6, and 5 months, respectively (Fig. 1b). The proposed IPSS-R defines a new intermediate risk group mainly composed by patients from the intermediate-1 IPSS risk category (84%, 47/56) and allowed us to identify 7% (11/150) of patients that were shifted from the intermediate-1 risk group into the high IPSS-R risk group. Although limit age of 60 years did not show statistical differences for predicting survival, our results confirm that younger good risk patients have significantly better prognosis than elderly counterparts (very low/ low risk patients: 125 vs. 64 months, p=0.014), while the age at diagnosis has no impact on disease outcome for higher risk patients [1-2, 7-8]. The proposed formula for an age-adjusted categorization [2] helped us to identify 19% (28/147) of short surviving patients among low risk IPSS-R patients with a median survival of 34 months (Fig. 1d). These patients showed, among relevant parameters, a gender ratio M/F of 3.0, a median age of 81 years, 2.5% of BM blasts, 9.1g/dL of haemoglobin level, 12 (43%) presented an abnormal karyotype and 17 died, including 6 patients with previous leukemic progression. It can be concluded that the IPSS-R system is simple to use since includes accessible variables showing a good reproducibility, effectiveness in predicting clinical outcome, and a refinement of the intermediate risk category in our WHO classified series.