Report on outcomes of hypomethylating therapy for analyzing prognostic value of Revised International Prognostic Scoring System for patients with lower-risk ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-11

AUTHORS

Yoo Jin Lee, Sung Woo Park, In Hee Lee, Jae Sook Ahn, Hyeoung Joon Kim, Joo Seop Chung, Ho Jin Shin, Won Sik Lee, Sang Min Lee, Young Don Joo, Hawk Kim, Ho Sup Lee, Yang Soo Kim, Yoon Young Cho, Joon Ho Moon, Sang Kyun Sohn

ABSTRACT

The outcomes for patients with lower-risk myelodysplastic syndromes (LR-MDS) by the International Prognostic Scoring System (IPSS) vary widely. For more precise prognostication, this study evaluates the prognostic value of revised IPSS with the response to hypomethylating therapy (HMT). Using the Korean MDS Working Party database, treatment outcomes for 236 patients with HMT were retrospectively evaluated. The patients were then reclassified into very low/low (VL/L), intermediate (INT), and high (H) risk groups according to IPSS-R. According to the HMT response, the 3-year overall survival (OS) did not differ between the response group (37.9 ± 9.1 %) and the stable group (52.9 ± 6.6 %, p = 0. 782). When reclassifying according to IPSS-R, 42 patients (20.8 %) were reclassified into the H risk group. Most of them did not have benefit from continued HMT and progressed to secondary failure. The median OS was 59.0 months (range, 40.0-77.9 months) for the VL/L risk group, 31 months (range, 22.7-439.3 months) for the INT risk group, and 20.0 months (range, 15.9-24.1 months) for the H risk group (p < 0.001). In the multivariate analysis, the following factors were associated with survival: age ≥ 65 (HR = 1.515, p = 0.023), ECOG ≥ 2 (HR = 2.968, p < 0.001), H risk group according to IPSS-R (HR = 3.054, p < 0.001), P/VP cytogenetic risk according to IPSS-R (HR = 4.912, p = 0.003), and transformation to AML (HR = 2.158, p = 0.002). If IPSS-R reclassifies LR-MDS patients as H risk, these patients should be considered for early allo-HCT, regardless of the current benefits from HMT. More... »

PAGES

1795-1804

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00277-016-2759-y

DOI

http://dx.doi.org/10.1007/s00277-016-2759-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1038091526

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27530461


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    "description": "The outcomes for patients with lower-risk myelodysplastic syndromes (LR-MDS) by the International Prognostic Scoring System (IPSS) vary widely. For more precise prognostication, this study evaluates the prognostic value of revised IPSS with the response to hypomethylating therapy (HMT). Using the Korean MDS Working Party database, treatment outcomes for 236 patients with HMT were retrospectively evaluated. The patients were then reclassified into very low/low (VL/L), intermediate (INT), and high (H) risk groups according to IPSS-R. According to the HMT response, the 3-year overall survival (OS) did not differ between the response group (37.9\u2009\u00b1\u20099.1\u00a0%) and the stable group (52.9\u2009\u00b1\u20096.6\u00a0%, p\u2009=\u20090. 782). When reclassifying according to IPSS-R, 42 patients (20.8\u00a0%) were reclassified into the H risk group. Most of them did not have benefit from continued HMT and progressed to secondary failure. The median OS was 59.0\u00a0months (range, 40.0-77.9\u00a0months) for the VL/L risk group, 31\u00a0months (range, 22.7-439.3\u00a0months) for the INT risk group, and 20.0\u00a0months (range, 15.9-24.1\u00a0months) for the H risk group (p\u2009<\u20090.001). In the multivariate analysis, the following factors were associated with survival: age\u2009\u2265\u200965 (HR\u2009=\u20091.515, p\u2009=\u20090.023), ECOG\u2009\u2265\u20092 (HR\u2009=\u20092.968, p\u2009<\u20090.001), H risk group according to IPSS-R (HR\u2009=\u20093.054, p\u2009<\u20090.001), P/VP cytogenetic risk according to IPSS-R (HR\u2009=\u20094.912, p\u2009=\u20090.003), and transformation to AML (HR\u2009=\u20092.158, p\u2009=\u20090.002). If IPSS-R reclassifies LR-MDS patients as H risk, these patients should be considered for early allo-HCT, regardless of the current benefits from HMT. ", 
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