https://scholars.lib.ntu.edu.tw/handle/123456789/634599
標題: | Validation of the molecular international prognostic scoring system in patients with myelodysplastic syndromes defined by international consensus classification | 作者: | WAN-HSUAN LEE Tsai, Ming-Tao Tsai, Cheng-Hong FENG-MING TIEN Lo, Min-Yen Tseng, Mei-Hsuan Kuo, Yuan-Yeh Liu, Ming-Chih YI-TSUNG YANG JUI-CHE CHEN JIH-LUH TANG Sun, Hsun-I Chuang, Yi-Kuang LIANG-IN LIN WEN-CHIEN CHOU CHIEN-CHIN LIN HSIN-AN HOU HWEI-FANG TIEN |
公開日期: | 9-八月-2023 | 卷: | 13 | 期: | 1 | 來源出版物: | Blood cancer journal | 摘要: | Myelodysplastic syndromes (MDS) have varied prognoses and require a risk-adapted treatment strategy for treatment optimization. Recently, a molecular prognostic model (Molecular International Prognostic Scoring System [IPSS-M]) that combines clinical parameters, cytogenetic abnormalities, and mutation topography was proposed. This study validated the IPSS-M in 649 patients with primary MDS (based on the 2022 International Consensus Classification [ICC]) and compared its prognostic power to those of the IPSS and revised IPSS (IPSS-R). Overall, 42.5% of the patients were reclassified and 29.3% were up-staged from the IPSS-R. After the reclassification, 16.9% of the patients may receive different treatment strategies. The IPSS-M had greater discriminative potential than the IPSS-R and IPSS. Patients with high, or very high-risk IPSS-M might benefit from allogeneic hematopoietic stem cell transplantation. IPSS-M, age, ferritin level, and the 2022 ICC categorization predicted outcomes independently. After analyzing demographic and genetic features, complementary genetic analyses, including KMT2A-PTD, were suggested for accurate IPSS-M categorization of patients with ASXL1, TET2, STAG2, RUNX1, SF3B1, SRSF2, DNMT3A, U2AF1, and BCOR mutations and those classified as MDS, not otherwise specified with single lineage dysplasia/multi-lineage dysplasia based on the 2022 ICC. This study confirmed that the IPSS-M can better risk-stratified MDS patients for optimized therapeutic decision-making. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/634599 | ISSN: | 2044-5385 | DOI: | 10.1038/s41408-023-00894-8 |
顯示於: | 醫學檢驗暨生物技術學系 |
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