Hou et al reported a risk stratification score for a patient with myelodysplasia. This incorporates the revised International Prognostic Scoring System with the status of 5 high risk mutations. The authors are from the National Taiwan University in Taipei.
Patient selection: myelodysplastic syndrome (MDS)
Parameters:
(1) age in years
(2) revised IPSS (IPSS-R) risk category
(3) mutation in CBL
(4) mutations in IDH2
(5) mutations in ASXL1
(6) mutations in DNMT3A
(7) mutations in TP53
Parameter
Finding
Points
age
0.025 * (age)
IPSS-R
very low or low
-1.184
intermediate, high, very high
0
mutations in CBL
no
0
yes
0.829
mutations in IDH2
no
0
yes
0.829
mutations in ASXL1
no
0
yes
0.442
mutations in DNMT3A
no
0
yes
0.452
mutations in TP53
no
0
yes
2.254
total score =
= SUM(points for all of the parameters)
Interpretattion:
• minimum score: around -0.8 (affected by age)
• maximum score: around 7.3 (affected by age)
• Receipt of an allogeneic hematopoietic stem cell transplant (HSCT) was associated with improved overall survival.
Total Score
Risk Group
Median Overall Survival
< -0.5
low
250.7 months
-0.5 to 0.5
intermediate
38.4 months
0.51 to 1.5
high
17 months
> 1.5
very high
8.9 months
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