Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores.
BACKGROUND: myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic clonal disorders. So, prognostic variables are important to separate patients with a similar biology and clinical outcome. We compared the importance of risk stratification in primary MDS of IPSS and WPSS with the...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2013-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC3855682?pdf=render |
id |
doaj-d1fde87bfdce475ea23c267395ff7ac6 |
---|---|
record_format |
Article |
spelling |
doaj-d1fde87bfdce475ea23c267395ff7ac62020-11-25T00:44:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01812e8104810.1371/journal.pone.0081048Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores.Suiellen C Reis-AlvesFabíola TrainaGuilherme HaradaPaula M CamposSara T O SaadKonradin MetzeIrene Lorand-MetzeBACKGROUND: myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic clonal disorders. So, prognostic variables are important to separate patients with a similar biology and clinical outcome. We compared the importance of risk stratification in primary MDS of IPSS and WPSS with the just described revision of IPSS (IPSS-R), and examined if variables obtained by bone marrow immunophenotyping could add prognostic information to any of the scores. METHODS: In this prospective study of 101 cases of primary MDS we compared the relation of patients' overall survival with WHO types, IPSS, IPSS-R, WPSS and phenotypic abnormalities of hematopoietic precursors. We examined aberrancies in myelomonocytic precursors and CD34(+) cells. Patients were censored when receiving chemotherapy or BM transplantation. Survival analysis was made by Cox regressions and stability of the models was examined by bootstrap resampling. RESULTS: MEDIAN AGE: 64 years (15-93). WHO types: 2 cases of 5q- syndrome, 7 of RA, 64 of RCDM and 28 of RAEB. In the univariate Cox analysis, increasing risk category of all scores, degree of anemia, higher percentage of BM blasts, higher number of CD34(+) cells and their myeloid fractions besides increasing number of phenotypic abnormalities detected were significantly associated with a shorter survival. In the multivariate analysis comparing the three scores, IPSS-R was the only independent risk factor. Comparing WPSS with phenotypic variables (CD34(+)/CD13(+) cells, CD34(+)/CD13(-) cells and "total alterations") the score and "CD34(+)/CD13(+) cells" remained in the model. When IPSS was tested together with these phenotypic variables, only "CD34(+)/CD13(+) cells", and "total alterations" remained in the model. Testing IPSS-R with the phenotypic variables studied, only the score and "CD34(+)/CD13(+) cells" entered the model. CONCLUSIONS: Immunophenotypic analysis of myelomonocytic progenitors provides additional prognostic information to all clinical scores studied. IPSS-R improved risk stratification in MDS compared to the former scores.http://europepmc.org/articles/PMC3855682?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Suiellen C Reis-Alves Fabíola Traina Guilherme Harada Paula M Campos Sara T O Saad Konradin Metze Irene Lorand-Metze |
spellingShingle |
Suiellen C Reis-Alves Fabíola Traina Guilherme Harada Paula M Campos Sara T O Saad Konradin Metze Irene Lorand-Metze Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores. PLoS ONE |
author_facet |
Suiellen C Reis-Alves Fabíola Traina Guilherme Harada Paula M Campos Sara T O Saad Konradin Metze Irene Lorand-Metze |
author_sort |
Suiellen C Reis-Alves |
title |
Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores. |
title_short |
Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores. |
title_full |
Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores. |
title_fullStr |
Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores. |
title_full_unstemmed |
Immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores. |
title_sort |
immunophenotyping in myelodysplastic syndromes can add prognostic information to well-established and new clinical scores. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2013-01-01 |
description |
BACKGROUND: myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic clonal disorders. So, prognostic variables are important to separate patients with a similar biology and clinical outcome. We compared the importance of risk stratification in primary MDS of IPSS and WPSS with the just described revision of IPSS (IPSS-R), and examined if variables obtained by bone marrow immunophenotyping could add prognostic information to any of the scores. METHODS: In this prospective study of 101 cases of primary MDS we compared the relation of patients' overall survival with WHO types, IPSS, IPSS-R, WPSS and phenotypic abnormalities of hematopoietic precursors. We examined aberrancies in myelomonocytic precursors and CD34(+) cells. Patients were censored when receiving chemotherapy or BM transplantation. Survival analysis was made by Cox regressions and stability of the models was examined by bootstrap resampling. RESULTS: MEDIAN AGE: 64 years (15-93). WHO types: 2 cases of 5q- syndrome, 7 of RA, 64 of RCDM and 28 of RAEB. In the univariate Cox analysis, increasing risk category of all scores, degree of anemia, higher percentage of BM blasts, higher number of CD34(+) cells and their myeloid fractions besides increasing number of phenotypic abnormalities detected were significantly associated with a shorter survival. In the multivariate analysis comparing the three scores, IPSS-R was the only independent risk factor. Comparing WPSS with phenotypic variables (CD34(+)/CD13(+) cells, CD34(+)/CD13(-) cells and "total alterations") the score and "CD34(+)/CD13(+) cells" remained in the model. When IPSS was tested together with these phenotypic variables, only "CD34(+)/CD13(+) cells", and "total alterations" remained in the model. Testing IPSS-R with the phenotypic variables studied, only the score and "CD34(+)/CD13(+) cells" entered the model. CONCLUSIONS: Immunophenotypic analysis of myelomonocytic progenitors provides additional prognostic information to all clinical scores studied. IPSS-R improved risk stratification in MDS compared to the former scores. |
url |
http://europepmc.org/articles/PMC3855682?pdf=render |
work_keys_str_mv |
AT suiellencreisalves immunophenotypinginmyelodysplasticsyndromescanaddprognosticinformationtowellestablishedandnewclinicalscores AT fabiolatraina immunophenotypinginmyelodysplasticsyndromescanaddprognosticinformationtowellestablishedandnewclinicalscores AT guilhermeharada immunophenotypinginmyelodysplasticsyndromescanaddprognosticinformationtowellestablishedandnewclinicalscores AT paulamcampos immunophenotypinginmyelodysplasticsyndromescanaddprognosticinformationtowellestablishedandnewclinicalscores AT saratosaad immunophenotypinginmyelodysplasticsyndromescanaddprognosticinformationtowellestablishedandnewclinicalscores AT konradinmetze immunophenotypinginmyelodysplasticsyndromescanaddprognosticinformationtowellestablishedandnewclinicalscores AT irenelorandmetze immunophenotypinginmyelodysplasticsyndromescanaddprognosticinformationtowellestablishedandnewclinicalscores |
_version_ |
1725276248472551424 |