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WPSS is a strong prognostic indicator for clinical outcome of allogeneic transplant for myelodysplastic syndrome in Southeast Asian patients

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Abstract

To better understand the predictive factors and improve clinical outcome of allogeneic transplant for patients with myelodysplastic syndrome (MDS), we retrospectively analyzed the post-transplant outcome of 60 Southeast Asian patients with MDS. Multivariate analysis showed that WHO classification-based Prognostic Scoring System (WPSS) significantly affect overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), and cumulative incidence of non-relapse mortality (CINRM). Stratified by WPSS into very low/low, intermediate, high, and very high-risk categories, 3-year OS was 100, 61, 37, and 18 % (p = 0.02); PFS was 100, 55, 32, and 18 % (p = 0.014); CIR was 12, 24, 38, and 59 % (p = 0.024); CINRM was 0, 6, 12, and 26 % (p = 0.037), respectively. WHO classification, Revised International Prognostic Scoring System (IPSS-R), IPSS-R-defined cytogenetic risk groups, donor gender, and acute and chronic graft vs host disease (GVHD) also influenced different aspects of transplant outcome. We found that WPSS is a powerful predictor of post-transplant outcome. WPSS provides an important model not only for prognostication but also for exploration of further post-transplant measures such as immunological maneuvers or novel therapy to improve the poor outcome of high-risk patients.

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Acknowledgments

The authors thank all the staff involved, including fellow doctors from other specialties, nurses, pharmacists, laboratory, and allied health personnel for their contribution in one way or other to build up the transplant program over the years. Dr. Liyuan Ma is sponsored by the Overseas Training Grant and Young Doctors Talent Development Program of Xinhua Hospital.

Conflict of interest

The authors have nothing to disclose.

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Authors and Affiliations

  1. Division of Hematology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

    Liyuan Ma & Siguo Hao

  2. Department of Hematology, Singapore General Hospital, Level 3, Academia, 20 College Road, Singapore, 169856, Singapore

    Liyuan Ma, Colin Diong, Yeow-Tee Goh, Sathish Gopalakrishnan, Aloysius Ho, William Hwang, Mickey Koh, Yvonne Loh, Patrick Tan & Yeh-Ching Linn

  3. Department of Hematology-Oncology, National University Cancer Institute, Singapore, Singapore

    Liang-Piu Koh, Zi-Yi Lim, Michelle Poon & Lip-Kun Tan

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  1. Liyuan Ma
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  2. Siguo Hao
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  3. Colin Diong
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  15. Yeh-Ching Linn
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Corresponding author

Correspondence to Yeh-Ching Linn.

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Suppl fig 1

OS stratified by aGVHD (present vs absent) (GIF 28 kb)

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CIR stratified by IPSS-R (very low/low vs intermediate vs high vs very high risk) (GIF 27 kb)

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CIR stratified by cytogenetic groups defined by IPSS-R (very low vs low vs intermediate vs high vs very high risk) (GIF 32 kb)

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CIR stratified by cGVHD (present vs absent) (GIF 24 kb)

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CINRM stratified by WHO classification (RCUD (RA)/RARS vs RCMD vs RAEB-1 vs RAEB-2) (GIF 27 kb)

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CINRM stratified by donor-recipient gender pair (female donor to male recipient vs others) (GIF 27 kb)

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CINRM stratified by cGVHD (present vs absent) (GIF 24 kb)

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Ma, L., Hao, S., Diong, C. et al. WPSS is a strong prognostic indicator for clinical outcome of allogeneic transplant for myelodysplastic syndrome in Southeast Asian patients. Ann Hematol 94, 761–769 (2015). https://doi.org/10.1007/s00277-014-2275-x

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  • DOI: https://doi.org/10.1007/s00277-014-2275-x

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