Cross-validation of prognostic scores in myelodysplastic syndromes on 386 patients from a single institution confirms importance of cytogenetics

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.