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Updated: Feb 7, 2026

Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
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Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome

Published on: October 3, 2018

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Prognosis of patients with intermediate risk IPSS-R myelodysplastic syndrome indicates variable outcomes and need for

Christopher B Benton1, Maliha Khan1, David Sallman2

  • 1Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas.

American Journal of Hematology
|July 28, 2018
PubMed

Insights

The International Prognostic Scoring System-Revised (IPSS-R) intermediate-risk myelodysplastic syndromes (MDS) have variable outcomes. Age, blasts, and RBC transfusions define distinct int-favorable and int-adverse groups with different survival.

Area of Science:

  • Hematology
  • Oncology
  • Clinical Research

Background:

  • The International Prognostic Scoring System-Revised (IPSS-R) is a standard for myelodysplastic syndromes (MDS) risk stratification.
  • The intermediate-risk (IPSS-R int-risk) subset of MDS patients has poorly defined outcomes and treatment strategies.

Purpose of the Study:

  • To analyze outcomes for patients with IPSS-R int-risk MDS.
  • To identify clinical factors influencing survival in this patient group.
  • To develop a refined prognostic model for IPSS-R int-risk MDS.

Main Methods:

  • Retrospective analysis of 298 IPSS-R int-risk MDS patients from a cohort of 3167.
  • Cox proportional hazard models used to identify significant prognostic factors for overall survival (OS).
  • Validation of a new prognostic classification using two independent datasets (>700 patients).

Main Results:

  • Age (≥66 years), peripheral blood blasts (≥2%), and red blood cell (RBC) transfusion history were associated with inferior survival.
  • Patients were classified into int-favorable and int-adverse groups with significantly divergent outcomes.
  • Median survival differences between groups ranged from 1.8 to 3.7 years across cohorts.

Conclusions:

  • Outcomes for IPSS-R int-risk MDS patients are highly variable.
  • A refined prognostication system stratifying patients into int-favorable and int-adverse groups is needed.
  • This study provides a validated model for improved risk stratification in intermediate-risk MDS.

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