IPSS-M outperforms IPSS-R in prognostic stratification and guides effective interventions for very High-Risk myelodysplastic syndrome patients undergoing allogeneic hematopoietic stem cell transplantation

IPSS-M outperforms IPSS-R in prognostic stratification and guides effective interventions for very High-Risk myelodysplastic syndrome patients undergoing allogeneic hematopoietic stem cell transplantation

Abstract Allogeneic hematopoietic stem cell transplantation represents a curative modality for patients with myelodysplastic syndrome (MDS), yet relapse risk persists. The prognostic performances of the Revised International Prognostic Scoring System (IPSS-R) and the Molecular International Prognost...

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Main Authors: Huixian Wu, Shuang Li, Jun Yang, Yu Cai, Huiying Qiu, Chongmei Huang, Yin Tong, Kun Zhou, Jiahua Niu, Xinxin Xia, Ying Zhang, Xiaowei Xu, Chang Shen, Baoxia Dong, Liping Wan, Xianmin Song
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Oncology
Subjects:
Myelodysplastic syndrome (MDS)
Allogeneic peripheral blood stem cell transplantation
Revised International Prognostic Scoring System (IPSS-R)
Molecular International Prognostic Scoring System (IPSS-M)
Prophylactic Intervention
Online Access:https://doi.org/10.1007/s12672-025-03155-1
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Summary:Abstract Allogeneic hematopoietic stem cell transplantation represents a curative modality for patients with myelodysplastic syndrome (MDS), yet relapse risk persists. The prognostic performances of the Revised International Prognostic Scoring System (IPSS-R) and the Molecular International Prognostic Scoring System (IPSS-M) for 129 MDS patients undergoing allogeneic peripheral blood stem cell transplantation (allo-PBSCT) were evaluated. Using IPSS-M, 29.5% of patients were reclassified to a higher risk and 14.0% to a lower risk compared to IPSS-R. The two-year recurrence-free survival (RFS) and overall survival (OS) post-transplant were similar across IPSS-R groups, but significantly lower in the very-high risk category with IPSS-M (P = 0.005 for RFS; P = 0.014 for OS). Multivariate analysis revealed that patient age (P = 0.009, P = 0.017), very-high risk category in IPSS-M (P = 0.003, P = 0.001), and KPS score (P = 0.034, P = 0.055) were independent factors for OS and RFS. Only very-high risk category in IPSS-M was the independent factor affecting cumulative incidence of relapse (P = 0.003). Prophylactic interventions for relapse significantly decreased the risk of relapse (P = 0.003) and increased the survival of patients in the very-high risk category (P = 0.002 for OS, P = 0.006 for RFS). The study suggested that the IPSS-M system could identify the high relapse risk patients post-transplant who may benefit from early prophylactic interventions.
ISSN:2730-6011

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