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Bone Marrow Transplant. 2017 Nov;52(11):1519-1525. doi: 10.1038/bmt.2017.171. Epub 2017 Sep 11.

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.

Author information

1
Department of Medicine, University of Cologne, Cologne, Germany.
2
Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
3
DKMS, German Bone Marrow Donor Center, Dresden, Germany.
4
Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
5
Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany.
6
Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Center, Helsinki, Finland.
7
Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium.
8
Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany.
9
Hematology, University Hospital, Basel, Switzerland.
10
Department of Bone Marrow Transplantation, University Hospital, Essen, Germany.
11
Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
12
TD7 (Stem Cell Transplant Unit), Turku University Hospital, Turku, Finland.
13
Department D'Hematologie, CHU Nantes, Nantes, France.
14
Nottingham University, Nottingham, UK.
15
Department of Haematology, University Medical Centre, Utrecht, The Netherlands.
16
CHU Bordeaux, Hôpital Haut-leveque, Pessac, France.
17
Servicio de Hematología-Hemoterapia, Hospital U. Marqués de Valdecilla, Santander, Spain.
18
Cancer and Haematology Centre, Churchill Hospital, Oxford, UK.
19
Hematology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
20
Department of Haematological Medicine, GKT School of Medicine, London, UK.
21
Department of Haematology, Addenbrookes Hospital, Cambridge, UK.
22
BMT Centre Leiden, Leiden University Hospital, Leiden, The Netherlands.
23
Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
24
Hématologie Clinique, Hopital A. Michallon, Grenoble, France.
25
Clinica Ematologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
26
Department of Hematology, Radboud University-Nijmegen Medical Centre, Nijmegen, The Netherlands.
27
Department of Hematology-BMT, Hopital St. Louis, Paris, France.
28
Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany.

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.

PMID:
28892084
PMCID:
PMC5671928
DOI:
10.1038/bmt.2017.171
[Indexed for MEDLINE]
Free PMC Article

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