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Validation of the revised IPSS at transplant in patients with myelodysplastic syndrome/transformed acute myelogenous leukemia receiving allogeneic stem cell transplantation: a retrospective analysis of the EBMT chronic malignancies working party.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2017 Nov; Vol. 52 (11), pp. 1519-1525. Date of Electronic Publication: 2017 Sep 11. - Publication Year :
- 2017
-
Abstract
- The International Prognostic Scoring System has been revised (IPSS-R) to predict prognosis of patients with myelodysplastic syndromes at diagnosis. To validate the use of the IPSS-R assessed before transplant rather than at diagnosis we performed a retrospective analysis of the EBMT database. A total of 579 patients had sufficient information available to calculate IPSS-R at transplant. Median overall survival (OS) from transplant was significantly different according to IPSS-R: very low 23.6 months, low 55.0 months, intermediate 19.7 months, high 13.5 months, very high 7.8 months (P<0.001). In a multivariate Cox model the following parameters were significant risk factors for OS: IPSS-R, graft source, age and prior treatment. Median relapse free survival also showed significant differences according to IPSS-R: very low: 23.6 months, low: 24.8 months, intermediate 10.6 months, high 7.9 months, very high 5.5 months (P<0.001). Multivariate risk factors for relapse-free survival (RFS) were: IPSS-R, reduced intensity conditioning, graft source and prior treatment. A trend for an increased relapse incidence was noted for very high risk IPSS-R. We conclude that the IPSS-R at transplant is a useful prognostic score for predicting OS and RFS after transplantation, capturing both disease evolution and response to prior treatment before transplant.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Databases, Factual
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation mortality
Humans
Leukemia, Myeloid, Acute mortality
Leukemia, Myeloid, Acute therapy
Male
Middle Aged
Myelodysplastic Syndromes mortality
Myelodysplastic Syndromes therapy
Retrospective Studies
Risk Factors
Survival Rate
Transplantation, Homologous
Young Adult
Hematopoietic Stem Cell Transplantation methods
Leukemia, Myeloid, Acute diagnosis
Myelodysplastic Syndromes diagnosis
Prognosis
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5365
- Volume :
- 52
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 28892084
- Full Text :
- https://doi.org/10.1038/bmt.2017.171