Volumen: 18 # Number : 1
Publication Date : Enero - Abril Year: 2014
Application of the revised International
Prognostic Scoring System (IPSS-R) for Myelodysplastic Syndromes (MDS) in 511 Argentinean patients
Authors: Belli CB, Bestach Y, Prtes MV, Sakamoto F
Alfonso G, Rosenhain M; Narbaitz M
Gonzalez J, Bengió R, Irene B Larripa I.
Abstract: The International Prognostic Scoring System, the gold standard for risk assessment in MDS, has been recently revised (IPSS-R). The aim of this study was to apply the IPSS-R in Argentinean MDS patients.
We retrospectively analyzed a cohort of 511 (290 patients belong to the MDS Registry promoted by the SAH) de novo MDS patients (1981-2013). The median age was 70 (17-92) with a gender ratio of 1.3. During the follow-up (median overall survival: 44 months), 22% evolved to AML and 43% died.
The demographic description, obtained percentages, survival times and time to leukemic evolution for our patients regarding cytogenetic, hematological parameters,
and IPSS subgroups were similar to the IWG-PM database. Patients were classified by IPSS-R as very-low (20%), low (41%), intermediate (15%), high (14%), and very-high risk (10%), with median survival of 125, 62, 34,19 and 13 months (p<0.001), and time to leukemic evolution
(25%) of 125, 124, 23, 6, and 5 months, respectively (p<0.001).
The IPSS-R showed effective separation of the IPSS risk categories (Kendall’s tau= 0.702) and the intermediate group was mainly (83%) composed by intermediate-1 IPSS risk patients. Age and gender sowed statistical differences
for predicting survival in the very low/ low risk group (p=0.001). The proposed age-adjusted categorization
helped us to identify 18% among low risk IPSS-R patients with an inferior median survival (23 months, p<0,001).
It can be concluded that the IPSS-R system was simple to use since includes accessible variables showing a good reproducibility and effectiveness in predicting clinical outcome in our series.
Key words: Myelodysplastic Syndromes, Prognosis,
IPSS-R
Pages : 17-25
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