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. 2024 Jul;296(1):53-67.
doi: 10.1111/joim.13790. Epub 2024 Apr 23.

Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS-M) prediction in myelodysplastic syndromes

Maria Creignou  1   2 , Elsa Bernard  3   4 , Alessandro Gasparini  5 , Anna Tranberg  1   6 , Gabriele Todisco  1   7 , Pedro Luis Moura  1 , Elisabeth Ejerblad  8 , Lars Nilsson  9 , Hege Garelius  10 , Petar Antunovic  11 , Fryderyk Lorenz  12 , Bengt Rasmussen  13 , Gunilla Walldin  1 , Teresa Mortera-Blanco  1 , Monika Jansson  1 , Magnus Tobiasson  1   6 , Chiara Elena  14 , Jacqueline Ferrari  14 , Anna Gallì  14 , Sara Pozzi  14 , Luca Malcovati  14 , Gustaf Edgren  15   16 , Michael J Crowther  5 , Martin Jädersten  1   6 , Elli Papaemmanuil  3 , Eva Hellström-Lindberg  1   6
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Free article

Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS-M) prediction in myelodysplastic syndromes

Maria Creignou et al. J Intern Med. 2024 Jul.
Free article

Abstract

Background: The Molecular International Prognostic Scoring System (IPSS-M) is the new gold standard for diagnostic outcome prediction in patients with myelodysplastic syndromes (MDS). This study was designed to assess the additive prognostic impact of dynamic transfusion parameters during early follow-up.

Methods: We retrieved complete transfusion data from 677 adult Swedish MDS patients included in the IPSS-M cohort. Time-dependent erythrocyte transfusion dependency (E-TD) was added to IPSS-M features and analyzed regarding overall survival and leukemic transformation (acute myeloid leukemia). A multistate Markov model was applied to assess the prognostic value of early changes in transfusion patterns.

Results: Specific clinical and genetic features were predicted for diagnostic and time-dependent transfusion patterns. Importantly, transfusion state both at diagnosis and within the first year strongly predicts outcomes in both lower (LR) and higher-risk (HR) MDSs. In multivariable analysis, 8-month landmark E-TD predicted shorter survival independently of IPSS-M (p < 0.001). A predictive model based on IPSS-M and 8-month landmark E-TD performed significantly better than a model including only IPSS-M. Similar trends were observed in an independent validation cohort (n = 218). Early transfusion patterns impacted both future transfusion requirements and outcomes in a multistate Markov model.

Conclusion: The transfusion requirement is a robust and available clinical parameter incorporating the effects of first-line management. In MDS, it provides dynamic risk information independently of diagnostic IPSS-M and, in particular, clinical guidance to LR MDS patients eligible for potentially curative therapeutic intervention.

Keywords: IPSS‐M; myelodysplastic syndromes; prognosis; survival; transfusion.

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References

    1. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. Review series the updated who classification of hematological malignancies the 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391–2405. Available from: http://ashpublications.org/blood/article‐pdf/127/20/2391/1393154/2391.pdf.
    1. Vardiman JW, Ergen Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;114(5):937–951. Available from: http://ashpublications.org/blood/article‐pdf/114/5/937/1486692/zh8031090....
    1. Khoury JD, Solary E, Abla O, Akkari Y, Alaggio R, Apperley JF, et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours: myeloid and histiocytic/dendritic neoplasms. Leukemia. 2022;36(7):1703–1719. Available from: https://doi.org/10.1038/s41375‐022‐01613‐1.
    1. Arber DA, Orazi A, Hasserjian RP, Borowitz MJ, Calvo KR, Kvasnicka HM, et al. International consensus classification of myeloid neoplasms and acute leukemias: integrating morphologic, clinical, and genomic data. Blood. 2022;140(11):1200–1228. Available from: http://ashpublications.org/blood/article‐pdf/140/11/1200/1921032/bloodbl....
    1. Nationellt kvalitetsregister myelodysplastiskt syndrom. Lund: RCC Syd; 2023. Available from: https://cancercentrum.se/syd/cancerdiagnoser/blod‐lymfom‐myelom/myelodys...

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