TY - JOUR
TI - Serum ferritin and ECOG performance status predict the response and improve the prognostic value of IPSS or IPSS-R in patients with high-risk myelodysplastic syndromes and oligoblastic acute myeloid leukemia treated with 5-azacytidine: a retrospective analysis of the Hellenic national registry of myelodysplastic and hypoplastic syndromes
AU - Papageorgiou, S.G.
AU - Kotsianidis, I.
AU - Bouchla, A.
AU - Symeonidis, A.
AU - Galanopoulos, A.
AU - Viniou, N.-A.
AU - Hatzimichael, E.
AU - Vassilakopoulos, T.P.
AU - Gogos, D.
AU - Megalakaki, A.
AU - Zikos, P.
AU - Diamantopoulos, P.
AU - Kourakli, A.
AU - Giannoulia, P.
AU - Papoutselis, M.
AU - Poulakidas, E.
AU - Arapaki, M.
AU - Vardi, A.
AU - Anagnostopoulos, A.
AU - Mparmparousi, D.
AU - Papaioannou, M.
AU - Bouronikou, E.
AU - Dimou, M.
AU - Papadaki, H.
AU - Panayiotidis, P.
AU - Pappa, V.
JO - Therapeutic Advances in Hematology
PY - 2020
VL - 11
TODO - null
SP - null
PB - SAGE Publications Ltd
SN - 2040-6207, 2040-6215
TODO - 10.1177/2040620720966121
TODO - alpha 2 globulin;  azacitidine;  C reactive protein;  granulocyte colony stimulating factor, acute myeloid leukemia;  adult;  aged;  Article;  biochemical analysis;  blood transfusion;  bone marrow biopsy;  bone marrow suppression;  bone marrow toxicity;  cytogenetics;  disease free survival;  dysplasia;  erythrocyte;  erythropoiesis;  female;  ferritin blood level;  human;  human tissue;  International Prognostic Scoring System;  International Prostate Symptom Score;  major clinical study;  male;  myelodysplastic syndrome;  overall survival;  prognosis;  progression free survival;  retrospective study;  risk assessment;  survival analysis;  thrombocyte transfusion;  treatment failure
TODO - Background: 5-azacytidine (5-AZA) improves survival of patients with higher-risk myelodysplastic syndromes (MDSs) and oligoblastic acute myeloid leukemia (AML); however, predictive factors for response and outcome have not been consistently studied. Methods: This study of the Hellenic MDS Study Group included 687 consecutive patients with higher-risk MDS and oligoblastic AML treated with 5-AZA. Results: The International Prognostic Scoring System (IPSS) revised version (IPSS-R), Eastern Cooperative Oncology Group Performance Status (ECOG PS) (0 or 1 versus ⩾2) and baseline serum ferritin (SF) levels > 520 ng/ml were shown to independently predict response to 5-AZA. In the survival analysis, the IPSS and IPSS-R risk classification systems along with the ECOG PS and SF levels > 520 ng/ml proved to be independent prognosticators for overall survival (OS), as well as for leukemia-free survival (LFS). Next, we built new multivariate models for OS and LFS, incorporating only ECOG PS and SF levels besides IPSS or IPSS-R risk classification systems. Thereby, the new modified IPSS and IPSS-R risk classification systems (H-PSS, H-PSS-R) could each discriminate a low, an intermediate and a high-risk patient group regarding OS and LFS. The H-PSS and H-PSS-R proved to be better predictors of OS than their previous counterparts as well as the French prognostic score, while the most powerful OS predictor was the new, H-PSS-R system. Conclusions: ECOG PS and SF levels > 520 ng/ml independently predict response to 5-AZA, OS and LFS. Their incorporation in the IPSS and IPSS-R scores enhances these scores’ predictive power in 5-AZA-treated higher-risk MDS and oligoblastic AML patients. © The Author(s), 2020.
ER -