Application of the Molecular International Prognostic Scoring System (IPSS-M) model in South-American MDS patients: A study from Argentina and Uruguay

LINCANGO YUPANKI, MARCO; ANDREOLI, VERONICA; GARCÍA RIVELLO, HERNÁN; ASINARI, MARIANA; BENDER, ANDREA; ALFERO, CINTIA; CATALAN, A; RAHHAL, MARILINA; DELAMER, ROCIO; MELA OSORIO, MARIA JOSE; NAVICKAS, ALICIA; GRILLÉ, SOFÍA; AGRIELLO, EVANGELINA; CASTRO, MARÍA BELEN; PERUSINI, MARIA AGUSTINA; ARBELBIDE, JORGE; BASQUIERA, ANA L; BELLI, CAROLINA B

Marseille

Congreso; 17th International Congress of Myelodysplastic Syndromes; 2023

MDS Foundation

Adecuate risk stratification in MDS is crucial for therapeutic decision and the IPSS-M model was recently devoloped incorporating molecular data. Availavility of molecular data in South-America is heterogenous dueto its high cost and poor reimbursements. We aimed to apply the IPSS-M to the first MDS/CMML South-American cohort with available clinical and targeting sequencing data.This retrospective analysis included 182 patients (145-MDS/37-CMML). Statistical analysis and IPSS-M meanscores were achieved with R(v4.2.2). Overall survival (OS) was defined as the time from diagnosis to death orthe last follow-up, censoring at transplantation. Harrell´s C-index was used for model discrimination.Our cohort showed a 1.3 sex ratio (M/F), 65.0 years of median age, 2.0% BM blasts, 9.5 g/dL hemoglobin and 30% of abnormal karyotypes; median follow-up was 20.6 months with 40 deaths. We identified 410 variantsinvolving 46 genes affecting 80% of patients. The IPSS-M stratified patients as VLR(11.5%), LR(34.1%),MLR/MHR(23.6%), HR(18.1%) and VHR(12.6%) (Figure). From IPSS-R, 61% of patients were re-stratified, 44% of LR pts were upstaged mostly (26%) to IPSS-M-MLR/MHR. Survival outcomes differences were noted between IPSS-R vs M, specially in higher risks: IR=60.7m (vsMR=53.5m), HR=53.6m (vs31.0m) and VHR=16.5m (vs18.7m). Furthermore, IPSS-M improved discrimination regarding OS as pointed by the C-index from 0.64 to 0.73.This first collaborative study from South-America validate the IPSS-M enhancing the discrimination of higher-risk patients. Molecular tests definitely help the hematologist with treatment decisions and highlights the needto include these studies within routine diagnostic assays, which will speed up their reimbursement by healthinsurance providers in our region.