Cross-validation of prognostic scores in myelodysplastic syndromes on 386 patients from a single institution confirms importance of cytogenetics
Cross-validation of prognostic scores in myelodysplastic syndromes on 386 patients from a single institution confirms importance of cytogenetics
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DOI：
10.1046/j.1365-2141.1999.01559.x
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发表时间：
1999-08-01
影响因子：
6.5
通讯作者：
Heinz, R
中科院分区：
文献类型：
--
作者：
Pfeilstöcker, M;Reisner, R;Heinz, R
在骨髓增生异常综合征（MDS）中，基于临床和形态学数据的不同预后风险分析系统用于预测生存。核型异常的诊断和预后相关性的数据促进了包括细胞遗传学在内的评分的发展。本研究的目的是评估和比较不同评分系统的解释力，并通过评估单个机构MDS患者的临床和实验室数据来评估细胞遗传学的额外解释力。386例MDS患者的数据可用，其中256例在诊断时进行了细胞遗传学分析，临床/形态学评分：伯恩茅斯、改良伯恩茅斯和杜塞尔多夫;计算包括细胞遗传学评分：洛桑-伯恩茅斯、里尔和国际预后评分系统（IPSS）在内的评分，并比较其对总生存期和白血病前期持续时间的预测能力。每项评分在两个终点上均具有显著相关性。计算不同的细胞遗传学畸变的预后价值，我们发现，区分无畸变的证据，单一的畸变不包括染色体7和8，染色体5，7或8和复杂的畸变畸变是很重要的。这些数据被纳入预后指数细胞遗传学（pi评分）。细胞遗传学评分显著提高了最佳临床/形态学评分在总生存期和白血病前期病程方面的预后价值。总之，我们的数据进一步强调了细胞遗传学对MDS预后预测的重要性。
In myelodysplastic syndromes (MDS) different prognostic risk analysis systems based on clinical and morphological data are used for predicting survival. Data on diagnostic and prognostic relevance of karyotype aberrations have prompted the development of scores including cytogenetics. The aim of this study was to assess and compare the explanatory power of different scoring systems and to assess the additional explanatory power of cytogenetics by evaluating the clinical and laboratory data of MDS patients from a single institution. Data of 386 MDS patients was available, with cytogenetic analysis at time of diagnosis in 256, Clinical/morphological scores: Bournemouth, modified Bournemouth and Dusseldorf; and scores including cytogenetics: Lausanne-Bournemouth, Lille and the International Prognostic Scoring System (IPSS), were calculated and their predictive power was compared for both overall survival and preleukaemic duration. Each of the scores had significant correlation on both endpoints. Calculating the prognostic value of different cytogenetic aberrations we found that differentiating between evidence for no aberration, single aberrations excluding chromosomes 7 and 8, aberrations on chromosomes 5, 7 or 8 and complex aberrations was important. These data were incorporated in a prognostic index cytogenetics' (pi score). Cytogenetic scores significantly improved the prognostic value of the best clinical/morphological score in regard to both overall survival and preleukaemic duration. In conclusion, our data further stress the importance of cytogenetics for predicting prognosis in MDS.