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. 2025 Jun;104(6):3251-3259.
doi: 10.1007/s00277-025-06443-6. Epub 2025 Jun 9.

Refinement of intermediate-risk Karyotypes according to the IPSS-R in patients with myelodysplastic neoplasms (MDS)

K Nachtkamp  1   2 , F Schulz  3 , A Kasprzak  3 , C Strupp  3 , B Hildebrandt  4 , M Pfeilstöcker  5 , P Valent  6   7 , B Blum  8 , A Giagounidis  9 , K Götze  10 , V Flatten  3 , S Dietrich  3 , G Kobbe  3 , D Haase  11 , N Gattermann  3 , U Germing  3
Affiliations

Refinement of intermediate-risk Karyotypes according to the IPSS-R in patients with myelodysplastic neoplasms (MDS)

K Nachtkamp et al. Ann Hematol. 2025 Jun.

Abstract

MDS patients show a heterogenous prognosis which can be stratified by the IPSS-R in order to derive therapeutic implications. Based on 618 patients with myelodysplastic neoplasms belonging to the cytogenetic intermediate-risk group according to IPSS-R, we show that this group is heterogeneous in terms of overall survival and cumulative risk of AML. The group can be reorganized into subgroups according to their prognostic impact. A small subgroup of patients with isolated -X or der(1;7) can be regarded as very-low-risk patients with a median survival time of 112 months and a cumulative AML progression rate of 9% after 2 years. A larger group of patients with either diverse aberrations of one chromosome or -Y + one additional aberration shows a benign course of the disease with a median survival time of 46 months and a cumulative AML progression rate of 26% after 2 years. A very large group of patients presenting with either + 8, +19, i(17q), + 21, +mar, del(9q), + 8 plus one other aberration, or del(7q) have a poor prognosis with a median survival time of 26 months and a cumulative AML progression rate of 32% after 2 years. In a very small set of patients with trisomy 11 the course of disease was similar to very-high-risk patients with a median survival time of 17 months only and a cumulative AML progression rate of 100% after 2 years. These findings could lead to a refinement of prognostic scoring systems such as the IPSS-R and the IPSS-M.

Keywords: IPSS-R; Intermediate-risk; Myelodysplastic neoplasms; New karyotype risk groups; Prognosis.

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Conflict of interest statement

Declarations. Consent: Written informed consent for participation was not required from the participants or the participants’ legal guardians/next of kin in accordance with the national legislation and institutional requirements. Competing interests: The authors declare no competing interests. Ethics approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The studies involving humans were approved by the Ethikkommission der Medizinischen Fakultaet der Heinrich Heine Universität Duesseldorf Votum 3973 Projekt MDS Register. The studies were conducted in accordance with the local legislation and institutional requirements. The human samples used in this study were acquired from a by-product of routine care or industry.

Figures

Fig. 1
Fig. 1
cumulative risk of survival according to the new karyotype risk categories (p < 0.0001)
Fig. 2
Fig. 2
cumulative risk of AML evolution according to the new karyotype risk categories (p < 0.0001)
Fig. 3
Fig. 3
Distribution of regrouped cytogenetic intermediate risk patients within IPSS-R risk groups
See this image and copyright information in PMC

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