Patient-reported outcomes enhance the survival prediction of traditional disease risk classifications: An international study in patients with myelodysplastic syndromes.

Autor: Efficace F; Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy., Cottone F; Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy., Abel G; Division of Population Sciences, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Niscola P; Hematology Unit, Sant'Eugenio Hospital, Rome, Italy., Gaidano G; Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy., Bonnetain F; Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.; Platform Quality of Life and Cancer, INSERM 1098, University of Franche-Comté, Besançon, France., Anota A; Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.; Platform Quality of Life and Cancer, INSERM 1098, University of Franche-Comté, Besançon, France., Caocci G; Department of Medical Sciences, University of Cagliari, Cagliari, Italy., Cronin A; Division of Population Sciences, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Fianchi L; Institute of Hematology, Catholic University of the Sacred Heart, Rome, Italy., Breccia M; Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy., Stauder R; Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria., Platzbecker U; Department of Medicine I, University Hospital Dresden Carl Gustav Carus, Dresden, Germany., Palumbo GA; UO Ematologia, AOU Policlinico-V Emanuele, Catania, Italy., Luppi M; Department of Hematology, University of Modena, Modena, Italy., Invernizzi R; Department of Internal Medicine, University of Pavia, San Matteo IRCCS Policlinic Foundation, Pavia, Italy., Bergamaschi M; San Martino Clinical Hematology Clinic, Genova, Italy., Borin L; Department of Hematology, San Gerardo Hospital, Monza, Italy., Di Tucci AA; Hematology and Bone Marrow Transplantation Unit, Armando Businco Hospital, Cagliari, Italy., Zhang H; Department of Hematology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China., Sprangers M; Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands., Vignetti M; Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy., Mandelli F; Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2018 Mar 15; Vol. 124 (6), pp. 1251-1259. Date of Electronic Publication: 2017 Dec 12.
DOI: 10.1002/cncr.31193
Abstrakt: Background: Current prognostic systems for myelodysplastic syndromes (MDS) are based on clinical, pathologic, and laboratory indicators. The objective of the current study was to develop a new patient-centered prognostic index for patients with advanced MDS by including self-reported fatigue severity into a well-established clinical risk classification: the International Prognostic Scoring System (IPSS).
Methods: A total of 469 patients with advanced (ie, IPSS intermediate-2 or high-risk) MDS were analyzed. Untreated patients (280 patients) were recruited into an international prospective cohort observational study to create the index. The index then was applied to an independent cohort including pretreated patients with MDS from the Dana-Farber Cancer Institute in Boston, Massachusetts (189 patients). At baseline, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30).
Results: A new prognostic index was developed: the FA-IPSS(h), in which FA stands for fatigue and h for higher-risk. This new risk classification enabled the authors to distinguish 3 subgroups of patients with distinct survival outcomes (ie, risk-1, risk-2, and risk-3). Patients classified as FA-IPSS(h) risk-1 had a median overall survival (OS) of 23 months (95% confidence interval [95% CI], 19-29 months), whereas those with risk-2 had a median OS of 16 months (95% CI, 12-17 months) and those with risk-3 had a median OS of 10 months (95% CI, 4-13 months). The predictive accuracy of this new index was higher than that of the IPSS alone in both the development cohort as well as in the independent cohort including pretreated patients.
Conclusions: The FA-IPSS(h) is a novel patient-centered prognostic index that includes patients' self-reported fatigue severity. The authors believe its use might enhance physicians' ability to predict survival more accurately in patients with advanced MDS. Cancer 2018;124:1251-9. © 2017 American Cancer Society.
(© 2017 American Cancer Society.)
Databáze: MEDLINE
Externí odkaz: