Researchers analyzing transplant outcomes of 2,133 patients with myelodysplastic syndromes (MDS) have developed a prognostic scoring system that is more predictive of overall survival when compared to the IPSS and IPSS-R systems. Patients studied underwent HLA matched or mismatched allogeneic hematopoietic cell transplantation (HCT) for MDS from 2000-2012, and outcomes were reported to CIBMTR (Center for International Blood and Marrow Transplant Research).
Patients were randomly divided into a training set (67%) to develop a prognostic scoring system and a validation data set (33%) to assess the predictive ability of the scoring system. The researchers assigned patients to good, intermediate, high, and very high risk groups, based on peripheral blood blasts ≥3% or platelet count <50 x 109/μL at transplantation, IPSS-R cytogenetic risk score, poor Karnofsky performance status, and older age at transplantation.
In order to determine if the proposed scoring system was superior to the IPSS or IPSS-R prognostic tools, the researchers compared the three scoring systems in the HLA-matched validation set using concordance probabilities and Brier scores in the 384 patients who had complete data for all three prognostic systems. The proposed scoring system was more predictive of overall survival when compared to the IPSS and IPSS-R using Brier (0.241, 0.252, and 0.249, respectively) and concordance probability tools (0.575, 0.538, and 0.554, respectively).