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Erschienen in: International Journal of Hematology 3/2023

28.06.2023 | Original Article

Real-world practice-based prognostic model for higher-risk myelodysplastic syndromes treated with azacitidine monotherapy: The Kyoto prognostic scoring system

verfasst von: Haruya Okamoto, Yu Inoue, Akihiro Miyashita, Yuka Kawaji-Kanayama, Shotaro Chinen, Takahiro Fujino, Taku Tsukamoto, Yuji Shimura, Shinsuke Mizutani, Hiroto Kaneko, Saeko Kuwahara-Ota, Shin-ichi Fuchida, Daichi Nishiyama, Koichi Hirakawa, Hitoji Uchiyama, Nobuhiko Uoshima, Eri Kawata, Junya Kuroda, KOTOSG investigators

Erschienen in: International Journal of Hematology | Ausgabe 3/2023

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Abstract

The prognostic impact of patient-related factors, including age, nutritional parameters, and inflammation status, in higher-risk myelodysplastic syndromes (HR-MDS) has been largely unexplored. This multicenter retrospective study aimed to establish a real-world practice-based prognostic model for HR-MDS by considering both disease- and patient-related parameters in 233 patients treated with AZA monotherapy at seven institutions. We found that anemia, presence of circulating blasts in peripheral blood, low absolute lymphocyte count, low total cholesterol (T-cho) and albumin serum levels, complex karyotype, and del(7q) or  – 7 were poor prognostic factors. Therefore, we developed a new prognostic model called the Kyoto Prognostic Scoring System (KPSS) by incorporating the two variables with the highest C-indexes (complex karyotype and serum T-cho level). The KPSS classified patients into the following three groups: good (0 risk factors), intermediate (1), and poor (2). Median overall survival for these groups was 24.4, 11.3, and 6.9, respectively (p < 0.001). The discriminatory power of the KPSS was higher than that of the traditional International Prognostic Scoring System. In conclusion, we identified several nutritional parameters with prognostic relevance in patients with HR-MDS and generated a prognostic model consisting of complex karyotype and serum T-cho level that enabled excellent risk stratification.
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Metadaten
Titel
Real-world practice-based prognostic model for higher-risk myelodysplastic syndromes treated with azacitidine monotherapy: The Kyoto prognostic scoring system
verfasst von
Haruya Okamoto
Yu Inoue
Akihiro Miyashita
Yuka Kawaji-Kanayama
Shotaro Chinen
Takahiro Fujino
Taku Tsukamoto
Yuji Shimura
Shinsuke Mizutani
Hiroto Kaneko
Saeko Kuwahara-Ota
Shin-ichi Fuchida
Daichi Nishiyama
Koichi Hirakawa
Hitoji Uchiyama
Nobuhiko Uoshima
Eri Kawata
Junya Kuroda
KOTOSG investigators
Publikationsdatum
28.06.2023
Verlag
Springer Nature Singapore
Erschienen in
International Journal of Hematology / Ausgabe 3/2023
Print ISSN: 0925-5710
Elektronische ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-023-03627-6

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