M. Pfeilstocker et al., Cross-validation of prognostic scores in myelodysplastic syndromes on 386 patients from a single institution confirms importance of cytogenetics, BR J HAEM, 106(2), 1999, pp. 455-463
In myelodysplastic syndromes (MDS) different prognostic risk analysis syste
ms based on clinical and morphological data are used for predicting surviva
l. Data on diagnostic and prognostic relevance of karyotype aberrations hav
e prompted the development of scores including cytogenetics. The aim of thi
s study was to assess and compare the explanatory power of different scorin
g systems and to assess the additional explanatory power of cytogenetics by
evaluating the clinical and laboratory data of MDS patients from a single
institution. Data of 386 MDS patients was available, with cytogenetic analy
sis at time of diagnosis in 256, Clinical/morphological scores: Bournemouth
, modified Bournemouth and Dusseldorf; and scores including cytogenetics: L
ausanne-Bournemouth, Lille and the International Prognostic Scoring System
(IPSS), were calculated and their predictive power was compared for both ov
erall survival and preleukaemic duration. Each of the scores had significan
t correlation on both endpoints. Calculating the prognostic value of differ
ent cytogenetic aberrations we found that differentiating between evidence
for no aberration, single aberrations excluding chromosomes 7 and 8, aberra
tions on chromosomes 5, 7 or 8 and complex aberrations was important. These
data were incorporated in a prognostic index cytogenetics' (pi score). Cyt
ogenetic scores significantly improved the prognostic value of the best cli
nical/morphological score in regard to both overall survival and preleukaem
ic duration. In conclusion, our data further stress the importance of cytog
enetics for predicting prognosis in MDS.