Proposal for a new risk model in myelodysplastic syndrome that accounts for events not considered in the original International Prognostic Scoring System (pages 1351–1361)
Hagop Kantarjian, Susan O'Brien, Farhad Ravandi, Jorge Cortes, Jianqin Shan, John M. Bennett, Alan List, Pierre Fenaux, Guillermo Sanz, Jean-Pierre Issa, Emil J. Freireich and Guillermo Garcia-Manero
Version of Record online: 10 JUL 2008 | DOI: 10.1002/cncr.23697
The investigators analyzed 1915 patients with myelodysplastic syndrome (MDS) and developed, by multivariate analysis, a prognostic model that predicted outcome of patients at any time during the course of their disease, regardless of prior therapy. The model was validated in a test group and added to the prognostic value of the International Prognostic Scoring System (IPSS) model in each IPSS risk group; the reverse (IPSS predicting outcome within each risk group of the new model) was not true. This improves on the existing IPSS which would be also applicable to only newly diagnosed patients with primary MDS (excludes secondary MDS and chronic myelomonocytic leukemia [CMML] with leukocytosis). The IPSS system would have allowed prognostic predictions in only 507 (26%) of patients referred to M. D. Anderson Cancer Center and would not be applicable to patients who have received prior therapies (which will soon become the most common form of referral to tertiary cancer centers and to accruals on investigational programs with the FDA approval and availability of hypomethylating agents for MDS and CMML).