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. 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

C Scheid  1 , L de Wreede  2   3 , A van Biezen  2 , C Koenecke  4 , G Göhring  5 , L Volin  6 , J Maertens  7 , J Finke  8 , J Passweg  9 , D Beelen  10 , J J Cornelissen  11 , M Itälä-Remes  12 , P Chevallier  13 , N Russell  14 , E Petersen  15 , N Milpied  16 , C Richard Espiga  17 , A Peniket  18 , J Sierra  19 , G Mufti  20 , C Crawley  21 , J H Veelken  22 , P Ljungman  23 , J Y Cahn  24 , E P Alessandrino  25 , T de Witte  26 , M Robin  27 , N Kröger  28
Affiliations

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

C Scheid et al. Bone Marrow Transplant. 2017 Nov.

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.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
OS according to IPSS-R at transplant.
Figure 2
Figure 2
RFS according to IPSS-R at transplant.
Figure 3
Figure 3
Cumulative incidence of relapse according to IPSS-R at transplant.
Figure 4
Figure 4
Cumulative incidence of non-relapse mortality according to IPSS-R at transplant.
See this image and copyright information in PMC

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