Prognostic value of the revised International Prognostic Scoring System five-group cytogenetic abnormality classification for the outcome prediction of hematopoietic stem cell transplantation in pediatric myelodysplastic syndrome

Shohei Yamamoto, Motohiro Kato, Kenichiro Watanabe, Sae Ishimaru, Daisuke Hasegawa, Maiko Noguchi, Asahito Hama, Maho Sato, Takashi Koike, Fuminori Iwasaki, Hiroshi Yagasaki, Yoshiyuki Takahashi, Yoshiyuki Kosaka, Yoshiko Hashii, Akira Morimoto, Yoshiko Atsuta, Daiichiro Hasegawa, Nao Yoshida

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3 Citations (Scopus)

Abstract

Cytogenetic abnormalities are a major risk factor for relapse after hematopoietic stem cell transplantation (HSCT) for myelodysplastic syndrome (MDS). We aimed to evaluate the value of the five-group cytogenetic classification according to the revised International Prognostic Scoring System (R-IPSS) for predicting the outcome after HSCT in pediatric patients with MDS. We retrospectively analyzed the Japanese registration data of 242 pediatric patients with MDS. According to the R-IPSS classification, 112 (45.5%) patients had good, 55 (22.7%) had intermediate, 64 (26.4%) had poor, and 11 (4.6%) had very poor cytogenetics. The 5-year overall survival (5yOS) was 72%, 69%, 59%, and 30% in the good, intermediate, poor, and very poor cytogenetic subgroups (p = 0.026), respectively. The very good, good, and intermediate subgroups were grouped into a “standard” subgroup and reclassified into three subgroups (standard, poor, and very poor). Patients with very poor risk had worse 5yOS (hazard ratio 2.17, 95% confidence interval (CI) 1.02–4.61; p = 0.04) and a much higher 5yCIR (hazard ratio 2.52, 95% CI 1.05–6.04; p = 0.04) than those of patients in the standard group in the multivariate analysis, indicating that very poor risk cytogenetic characteristics independently predicted worse outcome after HSCT in pediatric patients with MDS.

Original languageEnglish
Pages (from-to)3016-3023
Number of pages8
JournalBone Marrow Transplantation
Volume56
Issue number12
DOIs
Publication statusPublished - Dec 2021
Externally publishedYes

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