Validation and Improvement of the Molecular International Prognostic Scoring System in Chinese Patients with Myelodysplastic Syndromes

Overview

Journal Ann Hematol

Specialty Hematology

Date 2024 Dec 31

PMID 39738836

Authors

Nanfang Huang

Yang Song

Lingyun Wu

Qi He

Zheng Zhang

Juan Guo

Feng Xu

Chunkang Chang

Xiao Li

Affiliations

Soon will be listed here.

Abstract

Various prognostic models have been proposed to improve the accuracy of prognostic assessment for Myelodysplastic syndromes (MDS). Recently, the Molecular International Prognostic Scoring System (IPSS-M) has been developed. Here, we validated the accuracy of IPSS-M in Chinese MDS patients, and proposed a prognostic model more suitable for Chinese patients. We analyzed the clinical, molecular and cytogenetic data of 798 primary MDS patients, and compared the accuracy of IPSS-R and IPSS-M in predicting overall survival (OS) and acute myeloid leukemia (AML) transformation. Using Cox proportional hazards model, we screened out 14 genes that had significant impacts on OS and AML progression. In our study, 44.86% of individuals were reclassified from IPSS-R to IPSS-M, of whom 64.80% were upstaged and 35.2% were downstaged. IPSS-M showed better performance than IPSS-R in predicting AML transformation (C-index: 0.84 vs. 0.81), but it was similar to IPSS-R in OS (C-index: 0.77 vs. 0.76). By combining age, mutational data and IPSS-R, we developed a new prognostic model more suitable for the Chinese patients (c-index was 0.81 for OS and 0.89 for AML transformation, respectively).

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References

Sekeres M, Taylor J . Diagnosis and Treatment of Myelodysplastic Syndromes: A Review. JAMA. 2022; 328(9):872-880. DOI: 10.1001/jama.2022.14578. View

Ogawa S . Genetics of MDS. Blood. 2019; 133(10):1049-1059. PMC: 6587668. DOI: 10.1182/blood-2018-10-844621. View

Kennedy A, Shimamura A . Genetic predisposition to MDS: clinical features and clonal evolution. Blood. 2019; 133(10):1071-1085. PMC: 6405331. DOI: 10.1182/blood-2018-10-844662. View

Cheson B, Greenberg P, Bennett J, Lowenberg B, Wijermans P, Nimer S . Clinical application and proposal for modification of the International Working Group (IWG) response criteria in myelodysplasia. Blood. 2006; 108(2):419-25. DOI: 10.1182/blood-2005-10-4149. View

Bejar R, Stevenson K, Abdel-Wahab O, Galili N, Nilsson B, Garcia-Manero G . Clinical effect of point mutations in myelodysplastic syndromes. N Engl J Med. 2011; 364(26):2496-506. PMC: 3159042. DOI: 10.1056/NEJMoa1013343. View

Greenberg P, Tuechler H, Schanz J, Sanz G, Garcia-Manero G, Sole F . Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012; 120(12):2454-65. PMC: 4425443. DOI: 10.1182/blood-2012-03-420489. View

Hosono N . Genetic abnormalities and pathophysiology of MDS. Int J Clin Oncol. 2019; 24(8):885-892. DOI: 10.1007/s10147-019-01462-6. View

Haferlach T, Nagata Y, Grossmann V, Okuno Y, Bacher U, Nagae G . Landscape of genetic lesions in 944 patients with myelodysplastic syndromes. Leukemia. 2013; 28(2):241-7. PMC: 3918868. DOI: 10.1038/leu.2013.336. View

Kaisrlikova M, Vesela J, Kundrat D, Votavova H, Dostalova Merkerova M, Krejcik Z . RUNX1 mutations contribute to the progression of MDS due to disruption of antitumor cellular defense: a study on patients with lower-risk MDS. Leukemia. 2022; 36(7):1898-1906. PMC: 9252911. DOI: 10.1038/s41375-022-01584-3. View

10.

Xu F, Wu L, He Q, Wu D, Zhang Z, Song L . Exploration of the role of gene mutations in myelodysplastic syndromes through a sequencing design involving a small number of target genes. Sci Rep. 2017; 7:43113. PMC: 5318910. DOI: 10.1038/srep43113. View

11.

Hou H, Tsai C, Lin C, Chou W, Kuo Y, Liu C . Incorporation of mutations in five genes in the revised International Prognostic Scoring System can improve risk stratification in the patients with myelodysplastic syndrome. Blood Cancer J. 2018; 8(4):39. PMC: 5884776. DOI: 10.1038/s41408-018-0074-7. View

12.

Kewan T, Durmaz A, Bahaj W, Gurnari C, Terkawi L, Awada H . Molecular patterns identify distinct subclasses of myeloid neoplasia. Nat Commun. 2023; 14(1):3136. PMC: 10229666. DOI: 10.1038/s41467-023-38515-4. View

13.

Nazha A, Narkhede M, Radivoyevitch T, Seastone D, Patel B, Gerds A . Incorporation of molecular data into the Revised International Prognostic Scoring System in treated patients with myelodysplastic syndromes. Leukemia. 2016; 30(11):2214-2220. DOI: 10.1038/leu.2016.138. View

14.

Bersanelli M, Travaglino E, Meggendorfer M, Matteuzzi T, Sala C, Mosca E . Classification and Personalized Prognostic Assessment on the Basis of Clinical and Genomic Features in Myelodysplastic Syndromes. J Clin Oncol. 2021; 39(11):1223-1233. PMC: 8078359. DOI: 10.1200/JCO.20.01659. View

15.

Bernard E, Tuechler H, Greenberg P, Hasserjian R, Arango Ossa J, Nannya Y . Molecular International Prognostic Scoring System for Myelodysplastic Syndromes. NEJM Evid. 2024; 1(7):EVIDoa2200008. DOI: 10.1056/EVIDoa2200008. View

16.

Sauta E, Robin M, Bersanelli M, Travaglino E, Meggendorfer M, Zhao L . Real-World Validation of Molecular International Prognostic Scoring System for Myelodysplastic Syndromes. J Clin Oncol. 2023; 41(15):2827-2842. PMC: 10414702. DOI: 10.1200/JCO.22.01784. View

17.

Gurnari C, Gagelmann N, Badbaran A, Awada H, Dima D, Pagliuca S . Outcome prediction in myelodysplastic neoplasm undergoing hematopoietic cell transplant in the molecular era of IPSS-M. Leukemia. 2023; 37(3):717-719. PMC: 11104020. DOI: 10.1038/s41375-023-01820-4. View

18.

Baer C, Huber S, Hutter S, Meggendorfer M, Nadarajah N, Walter W . Risk prediction in MDS: independent validation of the IPSS-M-ready for routine?. Leukemia. 2023; 37(4):938-941. PMC: 10079546. DOI: 10.1038/s41375-023-01831-1. View

19.

Chen B, Zhao W, Jin J, Xue Y, Cheng X, Chen X . Clinical and cytogenetic features of 508 Chinese patients with myelodysplastic syndrome and comparison with those in Western countries. Leukemia. 2005; 19(5):767-75. DOI: 10.1038/sj.leu.2403688. View

20.

Matsuda A, Germing U, Jinnai I, Misumi M, Kuendgen A, Knipp S . Difference in clinical features between Japanese and German patients with refractory anemia in myelodysplastic syndromes. Blood. 2005; 106(8):2633-40. DOI: 10.1182/blood-2005-01-0040. View