Validation of the revised IPSS at transplant in patients with myelodysplastic syndrome/transformed acute myelogenous leukemia receiving allogeneic stem cell transplantation: a retrospective analysis of the EBMT chronic malignancies working party

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Title:	Validation of the revised IPSS at transplant in patients with myelodysplastic syndrome/transformed acute myelogenous leukemia receiving allogeneic stem cell transplantation: a retrospective analysis of the EBMT chronic malignancies working party
Author(s):	Scheid, C.; Wreede, L. de; Biezen, A. van; Koenecke, C.; Gohring, G.; Volin, L.; Maertens, J.; Finke, J.; Passweg, J.; Beelen, D.; Cornelissen, J.J.; Itala-Remes, M.; Chevallier, P.; Russell, N.; Petersen, E.; Milpied, N.; Espiga, C.R.; Peniket, A.; Sierra, J. ; Mufti, G.; Crawley, C.; Veelken, J.H.; Ljungman, P.; Cahn, J.Y.; Alessandrino, E.P.; Witte, T.J. de ; Robin, M.; Kroger, N.
Publication year:	2017
Source:	Bone Marrow Transplantation, vol. 52, iss. 11, (2017), pp. 1519-1525
ISSN:	0268-3369
DOI:	https://doi.org/10.1038/bmt.2017.171
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/181828
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Subject:	Radboudumc 2: Cancer development and immune defence RIMLS: Radboud Institute for Molecular Life Sciences
Organization:	Haematology Tumorimmunology
Journal title:	Bone Marrow Transplantation
Volume:	vol. 52
Issue:	iss. 11
Page start:	p. 1519
Page end:	p. 1525
Abstract:	The International Prognostic Scoring System has been revised (IPSS-R) to predict prognosis of patients with myelodysplastic syndromes at diagnosis. To validate the use of the IPSS-R assessed before transplant rather than at diagnosis we performed a retrospective analysis of the EBMT database. A total of 579 patients had sufficient information available to calculate IPSS-R at transplant. Median overall survival (OS) from transplant was significantly different according to IPSS-R: very low 23.6 months, low 55.0 months, intermediate 19.7 months, high 13.5 months, very high 7.8 months (P<0.001). In a multivariate Cox model the following parameters were significant risk factors for OS: IPSS-R, graft source, age and prior treatment. Median relapse free survival also showed significant differences according to IPSS-R: very low: 23.6 months, low: 24.8 months, intermediate 10.6 months, high 7.9 months, very high 5.5 months (P<0.001). Multivariate risk factors for relapse-free survival (RFS) were: IPSS-R, reduced intensity conditioning, graft source and prior treatment. A trend for an increased relapse incidence was noted for very high risk IPSS-R. We conclude that the IPSS-R at transplant is a useful prognostic score for predicting OS and RFS after transplantation, capturing both disease evolution and response to prior treatment before transplant.