Comparisons of prognostic scoring systems for myelodysplastic syndromes: aKorean multicenter study

We have conducted a multicenter collaborative retrospective analysis to eva luate clinical characteristics and to compare prognostic scoring systems of 149 Korean patients with myelodysplastic syndromes (MDS). The median age o f the patients was 53 years (range 17-82 years) with high of the patients b eing younger than 40 years. Median survival was 22.6 months, and 25 patient s (17%) progressed to acute myelogenous leukemia (AML) with a median interv al of 6 months (range 1-45 months). Major independent variables assesed by multivariate analysis were FAB subtypes and bone marrow (BM) blast percenta ges for survival and BM blast percentages for AML transformation. To compar e the various scoring systems in the prediction for survival and transforma tion to AML, FAB, Sanz and Bournemouth scoring systems were applied to all patients, while the international prognostic scoring system (IPSS), Lille a nd Toyama scoring systems were applied to 91 patients. The Sanz scoring sys tem (P < 0.0001), FAB classification (P < 0.0001), IPSS (P < 0.001), and To yama scoring system (P < 0.005) were highly predictive for survival showed greater discrimination than that of the other systems. For AML transformati on, the IPSS (P < 0.0001), Toyama scoring system (P < 0.0001), FAB classifi cation (P < 0.0001), and Lille scoring system (P < 0.005) successfully disc riminated risk groups. Although the prognostic factors and the distribution of age were different from those in Western reports, the IPSS and Toyama s coring system were applicable for predicting survival and leukemic transfor mation in Korean patients with MDS. (C) 1999 Elsevier Science Ltd. All righ ts reserved.