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Early transfusion p...
Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS-M) prediction in myelodysplastic syndromes
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- Creignou, Maria (author)
- Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Bernard, Elsa (author)
- Mem Sloan Kettering Canc Ctr, NY USA; Gustave Roussy, France; Gustave Roussy, France
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- Gasparini, Alessandro (author)
- Red Door Analyt, Sweden
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- Tranberg, Anna (author)
- Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Todisco, Gabriele (author)
- Karolinska Inst, Sweden; Humanitas Univ, Italy
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- Moura, Pedro Luis (author)
- Karolinska Inst, Sweden
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- Ejerblad, Elisabeth (author)
- Uppsala Univ, Sweden
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- Nilsson, Lars (author)
- Skane Univ Hosp, Sweden
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- Garelius, Hege (author)
- Sahlgrens Univ Hosp, Sweden
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- Antunovic, Petar (author)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hematologiska kliniken US
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- Lorenz, Fryderyk (author)
- Univ Hosp Umea, Sweden
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- Rasmussen, Bengt (author)
- Orebro Univ Hosp, Sweden
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- Walldin, Gunilla (author)
- Karolinska Inst, Sweden
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- Mortera-Blanco, Teresa (author)
- Karolinska Inst, Sweden
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- Jansson, Monika (author)
- Karolinska Inst, Sweden
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- Tobiasson, Magnus (author)
- Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Elena, Chiara (author)
- Univ Pavia, Italy
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- Ferrari, Jacqueline (author)
- Univ Pavia, Italy
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- Galli, Anna (author)
- Univ Pavia, Italy
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- Pozzi, Sara (author)
- Univ Pavia, Italy
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- Malcovati, Luca (author)
- Univ Pavia, Italy
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- Edgren, Gustaf (author)
- Karolinska Inst, Sweden; Soder Sjukhuset, Sweden
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- Crowther, Michael J. (author)
- Red Door Analyt, Sweden
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- Jaedersten, Martin (author)
- Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Papaemmanuil, Elli (author)
- Mem Sloan Kettering Canc Ctr, NY USA
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- Hellstroem-Lindberg, Eva (author)
- Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: Journal of Internal Medicine. - : WILEY. - 0954-6820 .- 1365-2796.
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background The Molecular International Prognostic Scoring System (IPSS-M) is the new gold standard for diagnostic outcome prediction in patients with myelodysplastic syndromes (MDS). This study was designed to assess the additive prognostic impact of dynamic transfusion parameters during early follow-up. Methods We retrieved complete transfusion data from 677 adult Swedish MDS patients included in the IPSS-M cohort. Time-dependent erythrocyte transfusion dependency (E-TD) was added to IPSS-M features and analyzed regarding overall survival and leukemic transformation (acute myeloid leukemia). A multistate Markov model was applied to assess the prognostic value of early changes in transfusion patterns. Results Specific clinical and genetic features were predicted for diagnostic and time-dependent transfusion patterns. Importantly, transfusion state both at diagnosis and within the first year strongly predicts outcomes in both lower (LR) and higher-risk (HR) MDSs. In multivariable analysis, 8-month landmark E-TD predicted shorter survival independently of IPSS-M (p < 0.001). A predictive model based on IPSS-M and 8-month landmark E-TD performed significantly better than a model including only IPSS-M. Similar trends were observed in an independent validation cohort (n = 218). Early transfusion patterns impacted both future transfusion requirements and outcomes in a multistate Markov model. Conclusion The transfusion requirement is a robust and available clinical parameter incorporating the effects of first-line management. In MDS, it provides dynamic risk information independently of diagnostic IPSS-M and, in particular, clinical guidance to LR MDS patients eligible for potentially curative therapeutic intervention.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- IPSS-M; myelodysplastic syndromes; prognosis; survival; transfusion
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Creignou, Maria
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Bernard, Elsa
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Gasparini, Aless ...
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Tranberg, Anna
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Todisco, Gabriel ...
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Moura, Pedro Lui ...
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show more...
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Ejerblad, Elisab ...
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Nilsson, Lars
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Garelius, Hege
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Antunovic, Petar
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Lorenz, Fryderyk
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Rasmussen, Bengt
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Walldin, Gunilla
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Mortera-Blanco, ...
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Jansson, Monika
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Tobiasson, Magnu ...
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Elena, Chiara
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Ferrari, Jacquel ...
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Galli, Anna
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Pozzi, Sara
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Malcovati, Luca
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Edgren, Gustaf
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Crowther, Michae ...
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Jaedersten, Mart ...
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Papaemmanuil, El ...
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Hellstroem-Lindb ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Journal of Inter ...
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Linköping University