Comparison of Molecular International Prognostic Scoring System (M-IPSS) and Revised International Prognostic Scoring System (R-IPSS) in Thai patients with myelodysplastic neoplasms

ABSTRACT

Introduction

Risk stratification is essential for treatment decision in myelodysplastic neoplasms (MDS). Molecular international prognostic scoring system (M-IPSS) has been recently developed combining somatic mutations and clinical information being used in the revised international prognostic scoring system (R-IPSS).

Objective

We aimed to explore the performances of M-IPSS and R-IPSS in Thai patients with MDS.

Method

MDS patients were stratified into risk categories using R-IPSS and M-IPSS scores. The performance of both models were evaluated for prognostic prediction.

Results

One hundred and sixty-two MDS patients were recruited from the multicenter study. Survival analysis revealed that both R-IPSS and M-IPSS were good prediction models with the Concordance Index (C-index) of 0.71 (95% Confidence interval [CI] 0.64–0.78) and 0.75 (95% CI 0.69–0.80), respectively (p = 0.22). Comparing the two, 13 of 162 (8%) cases were re-staged between lower and higher risks which would have affected treatment decisions.

Conclusion

Our study showed that R-IPSS score can be used for risk stratification in most Thai patients. A prediction model using somatic mutations specifically in Asian patients should be formulated in the future.

KEYWORDS:

• R-IPSS
• M-IPSS
• myelodysplastic neoplasms

Acknowledgements

Authors thank Miss Jiratchaya Sophonphan for the statistical analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

C.P. collected samples and clinical data, analyzed data, wrote the manuscript, and conceptualized the overall research. P.N., T.R., T.L., provided samples and clinical data. S.K. extracted DNA and performed targeted NGS. P.R. supervised, conceptualized the research, and wrote the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

This research was supported by grants from the Thailand Research Fund (grant number RDG6050109; C.P.), the Anandamahidol Foundation (C.P.), and the Thai Society of Hematology (C.P.).