A risk-adapted treatment strategy is mandatory for myelodysplastic syndromes (MDS). We refined the World Health Organization (WHO)-classification-based Prognostic Scoring System (WPSS) by determining the impact of the newer clinical and cytogenetic features, and we compared its prognostic power to that of the revised International Prognostic Scoring System (IPSS-R). A population of 5326 untreated MDS was considered. We analyzed single WPSS parameters and confirmed that the WHO classification and severe anemia provide important prognostic information in MDS. A strong correlation was found between the WPSS including the new cytogenetic risk stratification and WPSS adopting original criteria. We then compared WPSS with the IPSS-R prognostic system. A highly significant correlation was found between the WPSS and IPSS-R risk classifications. Discrepancies did occur among lower-risk patients in whom the number of dysplastic hematopoietic lineages as assessed by morphology did not reflect the severity of peripheral blood cytopenias and/or increased marrow blast count. Moreover, severe anemia has higher prognostic weight in the WPSS versus IPSS-R model. Overall, both systems well represent the prognostic risk of MDS patients defined by WHO morphologic criteria. This study provides relevant in formation for the implementation of risk-adapted strategies in MDS.

] Department of Hematology Oncology Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Pavia Italy [2] Department of Internal Medicine University of Pavia Pavia Italy

] Department of Hematology Oncology Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo Pavia Italy [2] Department of Molecular Medicine University of Pavia Pavia Italy

Cleveland Clinic Cleveland OH USA

Department of Hematology VU University Medical Center Amsterdam The Netherlands

Division of Hematology Stanford University Cancer Center Stanford CA USA

Elisabethinen Hospital Linz Austria

Federal University of Ceara Fortaleza Brazil

Fondazione Italiana Sindromi Mielodisplastiche c o SS Antonio e Biagio Hospital Alessandria Italy

Georg August Universität Göttingen Germany

Hanusch Hospital and L Boltzmann Cluster Oncology Vienna Austria

Hanusch Hospital Boltzmann Institute for Leukemia Research Vienna Austria

Heinrich Heine University Hospital Düsseldorf Germany

Hôpital Avicenne Assistance Publique Hôpitaux de Paris University Paris XIII Bobigny France

Hôpital Cochin AP HP University of Paris 5 Paris France

Hospital Universitario La Fe Valencia Spain

Hospital Universitario Vall d'Hebron Barcelona Spain

Institut de Recerca contra la Leucèmia Josep Carreras Barcelona Spain

Institute of Hematology and Blood Transfusion Praha Czech Republic

James P Wilmot Cancer Institute University of Rochester Medical Center Rochester NY USA

Medical University of Vienna Vienna Austria

Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan

Quest Diagnostics Nichols Institute Chantilly VA USA

St James's University Hospital Leeds UK

The University of Texas MD Anderson Cancer Center Houston TX USA

University of Chicago Comprehensive Cancer Research Center Chicago IL USA

University of Dundee Dundee Scotland UK

University of Freiburg Medical Center Freiburg Germany

Leukemia. 2015 Jul;29(7):1447. doi: 10.1038/leu.2015.92. PubMed

Zobrazit více v PubMed

J Clin Oncol. 2011 Jun 1;29(16):2240-6 PubMed

J Clin Oncol. 2006 Dec 1;24(34):5358-65 PubMed

Haematologica. 2006 Dec;91(12):1596-604 PubMed

Blood. 2014 Apr 10;123(15):2333-42 PubMed

N Engl J Med. 2011 Jun 30;364(26):2496-506 PubMed

Blood. 2007 Dec 15;110(13):4385-95 PubMed

Blood. 2014 Aug 28;124(9):1513-21 PubMed

Blood. 2013 Nov 21;122(22):3616-27; quiz 3699 PubMed

J Clin Oncol. 2013 Jul 20;31(21):2671-7 PubMed

Eur J Cancer. 2014 Dec;50(18):3198-205 PubMed

Am J Hematol. 2008 Oct;83(10):765-70 PubMed

Blood. 2013 Oct 24;122(17):2943-64 PubMed

Haematologica. 2011 Mar;96(3):441-9 PubMed

Ann Oncol. 2010 Jan;21(1):114-9 PubMed

Blood. 2009 Jul 30;114(5):937-51 PubMed

Blood. 2013 Dec 12;122(25):4021-34 PubMed

J Clin Oncol. 2011 May 20;29(15):1963-70 PubMed

Nature. 2011 Sep 11;478(7367):64-9 PubMed

Haematologica. 2013 Apr;98(4):568-75 PubMed

J Clin Oncol. 2005 Oct 20;23(30):7594-603 PubMed

N Engl J Med. 2005 Feb 10;352(6):536-8 PubMed

Haematologica. 2011 Oct;96(10):1433-40 PubMed

Leukemia. 2012 Jul;26(7):1730-41 PubMed

J Clin Oncol. 2012 Mar 10;30(8):820-9 PubMed

Leukemia. 2014 Sep;28(9):1793-8 PubMed

J Natl Compr Canc Netw. 2008 Oct;6(9):927-34 PubMed

Nat Commun. 2015 Jan 09;6:5901 PubMed

Lancet. 2014 Jun 28;383(9936):2239-52 PubMed

Blood. 2012 Aug 16;120(7):1398-408 PubMed

J Natl Compr Canc Netw. 2013 Jul;11(7):838-74 PubMed

Leukemia. 2014 Feb;28(2):241-7 PubMed

Blood. 2012 Sep 20;120(12):2454-65 PubMed

J Clin Oncol. 2009 Feb 10;27(5):754-62 PubMed

Blood. 1997 Mar 15;89(6):2079-88 PubMed

J Clin Oncol. 2007 Aug 10;25(23):3503-10 PubMed

N Engl J Med. 2011 Oct 13;365(15):1384-95 PubMed

Leuk Res. 2014 Jan;38(1):57-64 PubMed

Br J Haematol. 2014 Oct;167(1):100-9 PubMed

Leukemia. 2015 Jan;29(1):66-75 PubMed

Semin Oncol. 2011 Oct;38(5):627-34 PubMed

Br J Haematol. 2014 Feb;164(4):503-25 PubMed

Hematology Am Soc Hematol Educ Program. 2008;:166-75 PubMed

Late treatment-related mortality versus competing causes of death after allogeneic transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia

Time-dependent changes in mortality and transformation risk in MDS