Serum ferritin and ECOG performance status predict the response and improve the prognostic value of IPSS or IPSS-R in patients with high-risk myelodysplastic syndromes and oligoblastic acute myeloid leukemia treated with 5-azacytidine: a retrospective analysis of the Hellenic national registry of myelodysplastic and hypoplastic syndromes

Autor: Sotirios G. Papageorgiou, Ioannis Kotsianidis, Anthi Bouchla, Argyris Symeonidis, Athanasios Galanopoulos, Nora-Athina Viniou, Eleftheria Hatzimichael, Theodoros P. Vassilakopoulos, Dimitrios Gogos, Aikaterini Megalakaki, Panagiotis Zikos, Panagiotis Diamantopoulos, Alexandra Kourakli, Panagiota Giannoulia, Menelaos Papoutselis, Elias Poulakidas, Maria Arapaki, Anna Vardi, Achilles Anagnostopoulos, Despoina Mparmparousi, Maria Papaioannou, Eleni Bouronikou, Maria Dimou, Helen Papadaki, Panayiotis Panayiotidis, Vasiliki Pappa
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Therapeutic Advances in Hematology, Vol 11 (2020)
Druh dokumentu: article
ISSN: 2040-6215
20406207
DOI: 10.1177/2040620720966121
Popis: Background: 5-azacytidine (5-AZA) improves survival of patients with higher-risk myelodysplastic syndromes (MDSs) and oligoblastic acute myeloid leukemia (AML); however, predictive factors for response and outcome have not been consistently studied. Methods: This study of the Hellenic MDS Study Group included 687 consecutive patients with higher-risk MDS and oligoblastic AML treated with 5-AZA. Results: The International Prognostic Scoring System (IPSS) revised version (IPSS-R), Eastern Cooperative Oncology Group Performance Status (ECOG PS) (0 or 1 versus ⩾2) and baseline serum ferritin (SF) levels > 520 ng/ml were shown to independently predict response to 5-AZA. In the survival analysis, the IPSS and IPSS-R risk classification systems along with the ECOG PS and SF levels > 520 ng/ml proved to be independent prognosticators for overall survival (OS), as well as for leukemia-free survival (LFS). Next, we built new multivariate models for OS and LFS, incorporating only ECOG PS and SF levels besides IPSS or IPSS-R risk classification systems. Thereby, the new modified IPSS and IPSS-R risk classification systems (H-PSS, H-PSS-R) could each discriminate a low, an intermediate and a high-risk patient group regarding OS and LFS. The H-PSS and H-PSS-R proved to be better predictors of OS than their previous counterparts as well as the French prognostic score, while the most powerful OS predictor was the new, H-PSS-R system. Conclusions: ECOG PS and SF levels > 520 ng/ml independently predict response to 5-AZA, OS and LFS. Their incorporation in the IPSS and IPSS-R scores enhances these scores’ predictive power in 5-AZA-treated higher-risk MDS and oligoblastic AML patients.
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