Incorporation of molecular data into the Revised International Prognostic Scoring System in treated patients with myelodysplastic syndromes

Academic Article

Abstract

  • The Revised International Prognostic Scoring System (IPSS-R) was developed for untreated myelodysplastic syndrome (MDS) patients based on clinical data. We created and validated a new model that incorporates mutational data to improve the predictive capacity of the IPSS-R in treated MDS patients. Clinical and mutational data from treated MDS patients diagnosed between January 2000 and January 2012 were used to develop the new prognostic system. A total of 508 patients were divided into training (n=333) and validation (n=175) cohorts. Independent significant prognostic factors for survival included age, IPSS-R, EZH2, SF3B1 and TP53. Weighted coefficients for each factor were used to build the new linear predictive model, which produced four prognostic groups: low, intermediate-1, intermediate-2 and high with a median overall survival of 37.4, 23.2, 19.9 and 12.2 months, respectively, P<0.001. Significant improvement in the C-index of the new model (0.73) was observed compared with the IPSS-R (0.69). The new model predicted outcome both in a separate validation cohort and in another cohort of patients with paired samples at different time points during their disease course. The addition of mutational data to the IPSS-R makes it dynamic and enhances its predictive ability in treated MDS patients regardless of their initial or subsequent therapies.
  • Authors

    Published In

  • Leukemia  Journal
  • Digital Object Identifier (doi)

    Author List

  • Nazha A; Narkhede M; Radivoyevitch T; Seastone DJ; Patel BJ; Gerds AT; Mukherjee S; Kalaycio M; Advani A; Przychodzen B
  • Start Page

  • 2214
  • End Page

  • 2220
  • Volume

  • 30
  • Issue

  • 11