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Proposed score for survival of patients with myelodysplastic syndromes
Author(s) -
Sperr Wolfgang R.,
Kundi Michael,
Wimazal Friedrich,
Nösslinger Thomas,
SchönmetzlerMakrai Anabel,
Stauder Reinhard,
Krieger Otto,
Neukirchen Judith,
Germing Ulrich,
Pfeilstöcker Michael,
Valent Peter
Publication year - 2013
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12149
Subject(s) - international prognostic scoring system , medicine , myelodysplastic syndromes , multivariate analysis , comorbidity , framingham risk score , survival analysis , life expectancy , disease , population , bone marrow , environmental health
Background Patient selection for various therapies in myelodysplastic syndromes ( MDS ) is based on prognostic factors, scoring systems and the individual life expectancy. However, most established risk scores include mainly disease‐related parameters and thus focus on leukaemia‐transformation rather than survival. Patients and Methods To establish a risk score optimized for prediction of survival, we analysed international prognostic scoring system ( IPSS )‐related and IPSS ‐independent variables in 400 patients with primary MDS (median age: 71 years; range 18–91) of the A ustrian MDS platform. Patients were randomly split into a learning sample (60%) and validation sample (40%). External validation was performed on 93 patients from the H einrich H eine U niversity ( D uesseldorf/ G ermany). Results By multivariate analysis, IPSS , ferritin, age and comorbidities were found to be independent predictive variables concerning survival. Based on weighing these prognostic parameters against each other, we established a novel survival score employing IPSS , ferritin (< 900 ng/mL = 0; ≥ 900 ng/mL = 1), age (< 70 years = 0; 70–79 years = 1; ≥ 80 years = 1·5) and HCT ‐ CI comorbidity (low/intermediate = 0; high = 0·5). Using this score, four prognostic risk groups could be discriminated in the validation sample, with highly significant differences in life expectancy [median survival: L ow S (score 0), not reached; I nt‐1 S (score 0·5–1·0), 3·84 years; I nt‐2 S (score 1·5–2·0): 2·72 years; and H igh S (score > 2·0): 0·80 years; P < 0·0001]. Conclusions Our newly proposed score may be a useful tool for survival prediction in MDS and helpful in patient selection for various therapies in daily practice and clinical trials.