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Updated: May 5, 2026
Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
Published on: October 3, 2018
[Comparison of IPSS-R and IPSS-M in newly diagnosed myelodysplastic neoplasms: a single-center study]
Shunsuke Otsuki1, Seiichiro Katagiri1, Yuya Arai1
1Department of Hematology, Tokyo Medical University Hospital.
Abstract:
We compared the International Prognostic Scoring System-Revised (IPSS-R) to the International Prognostic Scoring System-Molecular (IPSS-M) in 30 patients with myelodysplastic neoplasms (MDS) newly diagnosed at our institution from January 2021 to February 2023. Molecular analysis was performed by myeloid panel. The median age was 66 years (range: 35-80), and classifications were MDS-LB (n=18), MDS IB-1 (n=1), MDS IB-2 (n=2), MDS-SF3B1 (n=2), MDS-biTP53 (n=1), and MN-pCT (n=6). Each patient had 0 to 8 (median 1) mutations. The most frequently detected mutation was the TET2 mutation, and others detected in>5 patients were U2AF1, TP53, and RUNX1 mutations. IPSS-R classification indicated that 2, 14, 5, 3, and 6 patients were very low, low, intermediate (Int), high, and very high risk, respectively, whereas the IPSS-M classification indicated that 3, 9, 7, 2, 4, and 5 cases were very low, low, moderate-low (ML), moderate-high (MH), high, and very high risk, respectively. Considering IPSS-M ML and MH as the equivalent to IPSS-R Int, 13 (43%) patients had a different risk level in the IPSS-M compared to the IPSS-R. One patient was rated low-risk by IPSS-R, but reclassified as high risk by IPSS-M. It is important to be mindful of this potential for significant discrepancies between risk assessments using IPSS-R and IPSS-M in some cases when making treatment decisions.
Insights
The International Prognostic Scoring System-Molecular (IPSS-M) reclassified risk in 43% of myelodysplastic neoplasms (MDS) patients compared to the IPSS-R. This highlights potential discrepancies in MDS risk assessment and treatment decisions.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- Myelodysplastic neoplasms (MDS) are a group of clonal hematopoietic stem cell disorders.
- Accurate risk stratification is crucial for guiding treatment decisions in MDS.
- Existing risk assessment tools include the International Prognostic Scoring System-Revised (IPSS-R).
Purpose of the Study:
- To compare the risk stratification of the IPSS-R with the newly developed IPSS-M in newly diagnosed MDS patients.
- To identify discrepancies in risk classification between the two systems.
- To evaluate the clinical implications of these discrepancies for treatment planning.
Main Methods:
- Retrospective analysis of 30 newly diagnosed MDS patients.
- Molecular analysis using a myeloid panel to identify mutations.
- Classification of patients using both IPSS-R and IPSS-M scoring systems.
- Comparison of risk categories assigned by each system.
Main Results:
- The IPSS-M reclassified the risk level in 13 (43%) of the 30 patients compared to the IPSS-R.
- A significant discrepancy was observed in one patient, who was reclassified from low-risk by IPSS-R to high-risk by IPSS-M.
- Common mutations included TET2, U2AF1, TP53, and RUNX1.
Conclusions:
- The IPSS-M offers a more refined risk assessment in MDS by incorporating molecular data.
- There is a potential for significant discrepancies between IPSS-R and IPSS-M, necessitating careful consideration during treatment decisions.
- Molecular profiling is essential for accurate MDS prognostication and personalized therapy.
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