Revised international prognostic scoring system for myelodysplastic syndromes

P.L. Greenberg, H. Tuechler, J. Schanz, G. Sanz, G. Garcia-Manero, F. Solé, J.M. Bennett, D. Bowen, P. Fenaux, F. Dreyfus, H. Kantarjian, A. Kuendgen, A. Levis, L. Malcovati, M. Cazzola, J. Cermak, C. Fonatsch, M.M. Le Beau, M.L. Slovak, O. KriegerM. Luebbert, J. Maciejewski, S.M.M. Magalhaes, Y. Miyazaki, M. Pfeilstöcker, M. Sekeres, W.R. Sperr, R. Stauder, Sudhir Tauro, P. Valent, T. Vallespi, A.A. Van De Loosdrecht, U. Germing, D. Haase

    Research output: Contribution to journalArticlepeer-review

    2357 Citations (Scopus)


    The International Prognostic Scoring Sytem (IPSS) is an important standard for ssessing prognosis of primary untreated adult patients with myelodysplastic syndromes (MDS). To refine the IPSS, MDS patient databases from international institutions were coalesced to assemble a much larger combined database (Revised-IPSS [IPSS-R], n = 7012, IPSS, n = 816) for analysis. Multiple statistically weighted clinical features were used to generate a prognostic categorization model. Bone marrow cytogenetics, marrow blast percentage, and cytopenias remained the basis of the new system. Novel components of the current analysis included: 5 rather than 3 cytogenetic prognostic subgroups with specific and new classifications of a number of less common cytogenetic subsets, splitting the low marrow blast percentage value, and depth of cytopenias. This model defined 5 rather than the 4 major prognostic categories that are present in the IPSS. Patient age, performance status, serum ferritin, and lactate dehydrogenase were significant additive features for survival but not for acute myeloid leukemia transformation. This system comprehensively integrated the numerous known clinical features into a method analyzing MDS patient prognosis more precisely than the initial IPSS. As such, this IPSS-R should prove beneficial for predicting the clinical outcomes of untreated MDS patients and aiding design and analysis of clinical trials in this disease.
    Original languageEnglish
    Pages (from-to)2454-2465
    Number of pages12
    Issue number12
    Publication statusPublished - 2012


    Dive into the research topics of 'Revised international prognostic scoring system for myelodysplastic syndromes'. Together they form a unique fingerprint.

    Cite this