Prediction of 18-month survival in patients with primary myelodysplastic syndrome a regression model and scoring system based on the combination of chromosome findings and the bournemouth score

Refinement of the international prognostic scoring system (IPSS) by including LDH as an additional prognostic variable to improve risk assessment in patients with primary myelodysplastic syndromes (MDS)

“…1,5,7,8,12 In the current study, patients with a complex karyotype or aberrations of chromosome 7 had a very poor prognosis, whereas the prognosis was uniformly good when patients presented with 20qÀ, 5qÀ, ÀY, or a normal karyotype. These data are in line with the IPSS 1 as well as with the results obtained by Sole et al, 19 Haase et al 20 and Oguma et al 21 The very good prognosis of patients with 5qÀ as sole anomaly was only demonstrable in patients with a normal medullary blast count, a finding which was recently also reported by Giagounidis et al 13 In our multicenter study, patients with 5qÀ syndrome had a median survival of 107 months, as compared to 18 months in patients with a 5qÀ anomaly in the context of RAEB.…”

“…This score has improved risk stratification in clinical trials and is also used for decision-making in clinical practice. When the IPSS was developed, databases from seven working groups, each of which had already proposed a scoring system for assessing survival and evolution to acute myeloid leukemia (AML) in previous analyses [2][3][4][5][6][7][8] were employed. 1 The IPSS includes three cytogenetic risk categories together with 'classic' prognostic parameters, namely medullary blast count and number of cytopenias.…”

Is FISH a relevant prognostic tool in myelodysplastic syndromes with a normal chromosome pattern on conventional cytogenetics? A study on 57 patients

“…In addition, many CC studies performed in the 1990s, well before the FISH era, have already documented that the probability of discovering karyotype defects is closely related to marrow blast cell percentage. [6][7][8][9][10][11][12][13] However, in our series no chromosome abnormality was revealed by CC, despite the high blast cell percentage and FISH was the only parameter that allowed us to identify individuals in the category of CC normal patients who had an adverse clinical outcome. In fact, FISH abnormal patients presented an EFS and an OS significantly inferior to those of normal FISH patients (Po10 À3 ) (Figures 1 and 2) and had a risk of AML progression eight-fold superior and death 15-fold superior to normal FISH patients (Table 5).…”

“…[4][5][6][7][8][9][10][11][12][13][14][15][16] In 1997, the international prognostic scoring system (IPSS) has further emphasized that karyotype is one of the most important prognostic indicators in MDS and can be used along with bone marrow blast cell percentage and number/degree of peripheral cytopenia to subdivide patients into four subgroups having distinct clinical outcomes. 17,18 However, conventional cytogenetics (CCs) reveals a normal karyotype in about 40-60% of patients.…”

“…17,18 However, conventional cytogenetics (CCs) reveals a normal karyotype in about 40-60% of patients. 1,2,[6][7][8][9][10][11][12][13] According to IPSS criteria, a normal chromosome pattern is considered prognostically favorable, even if it does not always indicate a positive clinical outcome. Therefore, new biological indicators are urgently needed in these patients in order to identify individuals at risk for AML evolution.…”