Navigation Links
Scoring system identifies MDS patients who have low-risk disease but a poor prognosis

HOUSTON - A new scoring system for a form of leukemia known as myelodysplastic syndrome (MDS) identifies patients who appear to have low-risk disease but actually have poor prospects of survival, researchers at The University of Texas M. D. Anderson Cancer Center report online at the journal Leukemia.

"We know an undefined group of MDS patients who are classified as low-risk by our present prognostic models will at some point have a sudden worsening of their disease. Right now, we don't know who these people are, but if we can identify them, we can start those with a poor prognosis on early treatment," says lead author Guillermo Garcia-Manero, M.D., associate professor in M. D. Anderson's Department of Leukemia.

Physicians tend to adopt a watch and wait approach to low-risk MDS patients, which Garcia-Manero says misses low-risk/poor prognosis patients. Myelodysplastic Syndromes are a group of conditions that cause insufficient production of blood cells, which is often lethal. About 10 percent of patients have their MDS transform into acute myelogenous leukemia.

Garcia-Manero and colleagues examined a number of potential molecular and demographic markers to develop a prognostic scoring system for this group by applying them to 856 patients treated at M. D. Anderson between 1976 and 2005. All were rated low or intermediate risk by the International Prognostic Scoring System, the mainstay model.

They found that a combination of older age, low platelet counts, anemia, a higher percentage of cancerous cells, or blasts, in the bone marrow and poor-risk cytogenetics (aberrant chromosomes) divided the 856 patients into three clearly defined groups:

  • The 182 patients who had few of these characteristics (Category 1) had a median survival of 80.3 months.
  • The 408 patients who fell into Category 2, an intermediate score, had a median survival of 26.6 months.
  • The 265 patients with the highest score had a median survival of 14.2 months.

When researchers applied the IPSS to the same patients, it failed to segregate patients with low or intermediate risk into the new test's risk categories.

Garcia-Manero says the scoring system is being applied in prospective clinical trials that are under way or planned at M. D. Anderson.

In the past three years, therapy for MDS has improved significantly, with approval of three new drugs: lenalidomide, a thalidomide derivative indicated for some patients, and two demethylating agents that turn on genes by removing chemical "off switches" that block gene expression.

Previously, most patients were observed or received supportive care until MDS transformed into acute myelogenous leukemia. They then received supportive care such as blood transfusions and AML treatments that included relatively harsh chemotherapy. Half the patients in the new study over the 30-year period died, and 90 percent of those were of myelodysplastic syndrome that had not transformed into AML, the researchers note.

"Identifying these low-risk, poor prognosis patients could allow us to be more aggressive, using medication at an earlier stage," Garcia-Manero notes. Few patients rated as low-risk receive donor bone marrow transplants, but a poor prognostic score would allow earlier consideration of that approach.

Garcia-Manero says the study needs to be replicated by other researchers and tested in prospective clinical trials, some of which are under way. The analysis of 856 patients was retrospective.


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

Related medicine news :

1. Using additional biopsy-scoring data may help determine prostate cancer prognosis
2. Different method of evaluating the urinary tract system reduces radiation dose
3. Lutheran Senior Services Partners with Silverchair Learning Systems to Enhance Employee Training and Education
4. Exempla Healthcare Contracts For Talismans Quality Donor System
5. Heartline(R) Fitness Systems Named to Inc. Magazines Inaugural List of the 5000 Fastest Growing Private Companies in U.S....
6. University of Wisconsin Hospitals and Clinics Complete System-Wide Conversion to Masimo SET Pulse Oximetry Technology
7. Plexus Systems Ranks in Top Third of the 2007 Inc. 5,000 with Three-Year Sales Growth of 226%
8. Document Security Systems (Amex: DMC) Invites You to a Landmark Event
9. Flu Vaccinations Begin on September 29 Maxim Health Systems to Provide 24,000 Flu Shot Clinics Nationwide
10. AtriCure Reports First Human Implant of the Cosgrove-Gillinov Left Atrial Appendage Occlusion System
11. American Heart Association Surgical Supplement Journal Report: Appropriate Hospital Discharge System Can Prevent Future Cardiac Events
Post Your Comments:
(Date:12/1/2015)... N.C. (PRWEB) , ... December 01, 2015 , ... The ... to drive awareness and funds for Multiple System Atrophy (MSA) research, timed today to ... Atrophy takes many things from patients including their ability to work and be productive, ...
(Date:12/1/2015)... (PRWEB) , ... December 01, 2015 , ... Royal River ... a new study that found post-menopausal women who took the nutritional supplement creatine, along ... women who trained but did not take creatine. , The report is part of ...
(Date:12/1/2015)... ... December 01, 2015 , ... Baptist Medical Center Jacksonville has ... the only hospital in the region providing what is known as the world’s ... patients were revealed recently at a medical conference and published in The New ...
(Date:12/1/2015)... (PRWEB) , ... December 01, 2015 , ... ... identification tests to continue the expansion of the company’s growing product line of ... for Chinook (Oncorhynchus tshawytscha) and Sockeye (Oncorhynchus nerka) – allow InstantLabs to offer ...
(Date:12/1/2015)... ... December 01, 2015 , ... Diabetic foot wounds ... Podiatrists are well aware that psychology-based patient non-compliance (disobedience of a health care ... to diseases of the diabetic foot. The American Board of Multiple Specialties ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... --> --> ... Acid Labeling Market by Product (Reagents & Kits, Services), ... Vitro Transcription, Reverse Transcription, End Labeling), by Region - ... market is expected to reach USD 1,925.7 Million by ... a CAGR of 8.65%. Browse 77 market ...
(Date:12/1/2015)... 1, 2015 Building on its 25-year ... Johnson (NYSE: JNJ ) today announced four ... to significantly reduce the burden of HIV incidence, ... percent of new HIV infections among adolescents in ... Day, these new initiatives include collaborations with the ...
(Date:12/1/2015)... DUBLIN , Dec. 01, 2015 ... ) has announced the addition of ... Testing Market: Campylobacter, Cryptosporidium, E. Coli, ... Yersinia" report to their offering. ... announced the addition of the ...
Breaking Medicine Technology: