Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 902-910 |
| Number of pages | 9 |
| Journal | Blood |
| Volume | 128 |
| Issue number | 7 |
| Early online date | 22 Jun 2016 |
| DOIs | |
| Publication status | Published - 18 Aug 2016 |
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Time-dependent changes in mortality and transformation risk in MDS. / Pfeilstocker, Michael (Lead / Corresponding author); Tuechler, Heinz ; Sanz, Guillermo ; Schanz, Julie ; Garcia-Manero, Guillermo; Solé, Françesc; Bennett, John M.; Bowen, David; Fenaux, Pierre; Dreyfus, Francois; Kantarjian, Hagop; Kuendgen, Andrea; Malcovati, Luca; Cazzola, Mario; Cermak, Jaroslav ; Levis, Alessandro; Luebbert, Michael ; Maciejewski, Jaroslaw; Machherndl-Spandl, Sigrid; Magalhaes, Silvia M.M.; Miyazaki, Yasushi; Sekeres, Mikkael A. ; Sperr, Wolfgang R.; Stauder, Reinhard; Tauro, Sudhir; Valent, Peter; Vallespi, Teresa; Van De Loosdrecht, Arjan A. ; Germing, Ulrich ; Haase, Detlef ; Greenberg, Peter L.
In: Blood, Vol. 128, No. 7, 18.08.2016, p. 902-910.Research output: Contribution to journal › Article
TY - JOUR
T1 - Time-dependent changes in mortality and transformation risk in MDS
AU - Pfeilstocker, Michael
AU - Tuechler, Heinz
AU - Sanz, Guillermo
AU - Schanz, Julie
AU - Garcia-Manero, Guillermo
AU - Solé, Françesc
AU - Bennett, John M.
AU - Bowen, David
AU - Fenaux, Pierre
AU - Dreyfus, Francois
AU - Kantarjian, Hagop
AU - Kuendgen, Andrea
AU - Malcovati, Luca
AU - Cazzola, Mario
AU - Cermak, Jaroslav
AU - Levis, Alessandro
AU - Luebbert, Michael
AU - Maciejewski, Jaroslaw
AU - Machherndl-Spandl, Sigrid
AU - Magalhaes, Silvia M.M.
AU - Miyazaki, Yasushi
AU - Sekeres, Mikkael A.
AU - Sperr, Wolfgang R.
AU - Stauder, Reinhard
AU - Tauro, Sudhir
AU - Valent, Peter
AU - Vallespi, Teresa
AU - Van De Loosdrecht, Arjan A.
AU - Germing, Ulrich
AU - Haase, Detlef
AU - Greenberg, Peter L.
N1 - This work was in part supported by the MDS Foundation, Inc.
PY - 2016/8/18
Y1 - 2016/8/18
N2 - In myelodysplastic syndromes (MDS) evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study we describe changes in risk over time, the consequences for basal prognostic scores and their potential clinical implications. Major MDS prognostic risk scoring systems (IPSS, IPSS-R, WPSS, LRPSS) and their constituent individual predictors were analyzed in 7,212 primary untreated MDS patients from the IWG-PM database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. In higher risk MDS, hazards regarding mortality and AML transformation diminished over time from diagnosis, whereas they remained stable in lower risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and essentially equivalent after five years. This fact led to loss of prognostic power of different scoring systems considered more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management the differing development of risks suggested a reasonable division into lower and higher risk MDS based on the IPSS-R at a cut-off of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower risk patients at diagnosis remain “constant lower risk", while "initially high risk" patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making.
AB - In myelodysplastic syndromes (MDS) evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study we describe changes in risk over time, the consequences for basal prognostic scores and their potential clinical implications. Major MDS prognostic risk scoring systems (IPSS, IPSS-R, WPSS, LRPSS) and their constituent individual predictors were analyzed in 7,212 primary untreated MDS patients from the IWG-PM database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. In higher risk MDS, hazards regarding mortality and AML transformation diminished over time from diagnosis, whereas they remained stable in lower risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and essentially equivalent after five years. This fact led to loss of prognostic power of different scoring systems considered more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management the differing development of risks suggested a reasonable division into lower and higher risk MDS based on the IPSS-R at a cut-off of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower risk patients at diagnosis remain “constant lower risk", while "initially high risk" patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making.
U2 - 10.1182/blood-2016-02-700054
DO - 10.1182/blood-2016-02-700054
M3 - Article
VL - 128
SP - 902
EP - 910
JO - Blood
JF - Blood
SN - 0006-4971
IS - 7
ER -