Revised International Prognostic Scoring System for Myelodysplastic Syndromes
Revised International Prognostic Scoring System for Myelodysplastic Syndromes
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DOI：
10.1182/blood-2012-03-420489
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发表时间：
2012-09-20
期刊：
影响因子：
20.3
通讯作者：
Haase, Detlef
中科院分区：
文献类型：
--
作者：
Greenberg, Peter L.;Tuechler, Heinz;Haase, Detlef
国际预后评分系统（IPSS）是评估初治成人骨髓增生异常综合征（MDS）患者预后的重要标准。为了完善IPSS，合并了来自国际机构的MDS患者数据库，以组成一个更大的合并数据库（修订版IPSS [IPSS-R]，n = 7012，IPSS，n = 816）进行分析。多个统计加权的临床特征用于生成预后分类模型。骨髓细胞遗传学、骨髓原始细胞百分比和血细胞减少仍然是新系统的基础。当前分析的新组成部分包括：5个而不是3个细胞遗传学预后亚组，具有一些不太常见的细胞遗传学亚组的特定和新分类，分裂低骨髓原始细胞百分比值和血细胞减少症的深度。该模型定义了5个而不是IPSS中存在的4个主要预后类别。患者年龄、体力状态、血清铁蛋白和乳酸脱氢酶是生存率的重要附加特征，但不是急性髓性白血病转化的重要附加特征。该系统将众多已知的临床特征综合到一种比初始IPSS更精确地分析MDS患者预后的方法中。因此，该IPSS-R应被证明有利于预测未经治疗的MDS患者的临床结局，并有助于设计和分析这种疾病的临床试验。（血。2012;120（12）：2454-2465）
The International Prognostic Scoring Sytem (IPSS) is an important standard for ssessing prognosis of primary untreated adult patients with myelodysplastic syndromes (MDS). To refine the IPSS, MDS patient databases from international institutions were coalesced to assemble a much larger combined database (Revised-IPSS [IPSS-R], n = 7012, IPSS, n = 816) for analysis. Multiple statistically weighted clinical features were used to generate a prognostic categorization model. Bone marrow cytogenetics, marrow blast percentage, and cytopenias remained the basis of the new system. Novel components of the current analysis included: 5 rather than 3 cytogenetic prognostic subgroups with specific and new classifications of a number of less common cytogenetic subsets, splitting the low marrow blast percentage value, and depth of cytopenias. This model defined 5 rather than the 4 major prognostic categories that are present in the IPSS. Patient age, performance status, serum ferritin, and lactate dehydrogenase were significant additive features for survival but not for acute myeloid leukemia transformation. This system comprehensively integrated the numerous known clinical features into a method analyzing MDS patient prognosis more precisely than the initial IPSS. As such, this IPSS-R should prove beneficial for predicting the clinical outcomes of untreated MDS patients and aiding design and analysis of clinical trials in this disease. (Blood. 2012;120(12):2454-2465)