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Early transfusion p...
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Creignou, MariaKarolinska Institutet
(author)
Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS-M) prediction in myelodysplastic syndromes
- Article/chapterEnglish2024
Publisher, publication year, extent ...
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2024
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WILEY,2024
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Numbers
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LIBRIS-ID:oai:DiVA.org:liu-203083
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-203083URI
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https://doi.org/10.1111/joim.13790DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:155734371URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies|Edward P. Evans Foundation
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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.
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Bernard, ElsaMem Sloan Kettering Canc Ctr, NY USA; Gustave Roussy, France; Gustave Roussy, France
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Gasparini, AlessandroRed Door Analyt, Sweden
(author)
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Tranberg, AnnaKarolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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Todisco, GabrieleKarolinska Inst, Sweden; Humanitas Univ, Italy
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Moura, Pedro LuisKarolinska Institutet
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Ejerblad, ElisabethUppsala Univ, Sweden
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Nilsson, LarsSkane Univ Hosp, Sweden
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Garelius, HegeSahlgrens Univ Hosp, Sweden
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Antunovic, PetarLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hematologiska kliniken US(Swepub:liu)petan27
(author)
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Lorenz, FryderykUniv Hosp Umea, Sweden
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Rasmussen, BengtOrebro Univ Hosp, Sweden
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Walldin, GunillaKarolinska Inst, Sweden
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Mortera-Blanco, TeresaKarolinska Institutet
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Jansson, MonikaKarolinska Institutet
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Tobiasson, MagnusKarolinska Institutet
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Elena, ChiaraUniv Pavia, Italy
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Ferrari, JacquelineUniv Pavia, Italy
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Galli, AnnaUniv Pavia, Italy
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Pozzi, SaraUniv Pavia, Italy
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Malcovati, LucaUniv Pavia, Italy
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Edgren, GustafKarolinska Institutet
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Crowther, Michael J.Karolinska Institutet
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Jaedersten, MartinKarolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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Papaemmanuil, ElliMem Sloan Kettering Canc Ctr, NY USA
(author)
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Hellstroem-Lindberg, EvaKarolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
(author)
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Karolinska InstitutetMem Sloan Kettering Canc Ctr, NY USA; Gustave Roussy, France; Gustave Roussy, France
(creator_code:org_t)
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In:Journal of Internal Medicine: WILEY0954-68201365-2796
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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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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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