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Prognostic model developed for MDS related to prior cancer therapy

ssociated with overall survival when considered as isolated, single variables.

Next, the researchers conducted a multi-variable analysis that narrowed factors reducing overall survival to seven:

  • Age 65 or older.
  • ECOG performance status scores of 2-4. (Eastern Cooperative Oncology Group criteria range from 0, which means fully active, to 4, signifying complete disability).
  • Cytogenetics. Having at least seven chromosomal alterations and/or complex cytogenetics.
  • Two MDS subgroups as determined by World Health Organization Criteria. RARS and RAEB-1/2.
  • Serum hemoglobin levels of less than 11g/dL.
  • Platelet levels of less than 50.
  • Dependency on blood transfusions.

Prognostic model sorts patients into three risk groups

Garcia-Manero and colleagues created a novel prognostic model that incorporated these multivariate factors and divided patients into three categories:

  • Good prognosis - 57 patients fell into this group by having 0-2 of the multivariate risk characteristics. Their median survival was 34 months.
  • Intermediate prognosis - 154 patients in this category had 3-4 risk factors and a median survival of 12 months.
  • Poor prognosis - 61 patients had 5-7 risk factors and a median survival of only five months.

The model also predicted one-year leukemia-free survival of 96 percent in the good category, 84 percent for intermediate, and 72 percent for the poor.

Model validated in a test group of patients

The researchers validated the model by applying it to an additional 189 treatment-related cases diagnosed between 2008 and 2010. Median survival rates in the test group were:

  • Good - 26 months
  • Intermediate - 13 months
  • Poor - 7 months.

"We believe this model will facilitate development of risk-adapted treatment strategies for patients with treatment-related myelodysplastic syndromes," Garcia-Manero said.

Contact: Scott Merville
University of Texas M. D. Anderson Cancer Center

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