MayoMedicalLaboratories.com/communique Volume 41 No. 2

Current prognostic model

Variable Overall survival

UnivariableP value

Odds ratio(95% CI)

MultivariableP value

Odds ratio(95% CI)

IPSS IPSS score

Intermediate-1 <.001 2.9 (1.7-4.8) .15 1.8 (0.8-3.9)

Intermediate-2 <.001 7.0 (4.1-12.2) .93 1.1 (0.5-5.5)

High <.001 14 (7.1-27.6) .83 0.8 (0.1-7.5)

Age .02 0.98 (0.97-0.99) .98 1.0 (0.98-1.01)

Sex: male .78 1.1 (0.7-1.5) .88 1.0 (0.7-1.5)

No. of cytopenias: 2 or 3 <.001 1.6 (1.4-1.9) .09 0.7 (0.4-1.1)

Bone marrow blast percentage categories <.001 3.9 (2.9-5.1) .002 5.2 (1.9-14.7)

FAB classification

RCMD .003 2.6 (1.4-5.0) .03 2.1 (1.1-4.2)

RAEB-1 <.001 9.8 (4.9-19.2) <.001 3.9 (1.7-8.9)

RAEB-2 <.001 12.5 (6.5-24) .36 1.7 (0.5-5.5)

Cytogenetic categories

Intermediate .52 1.2 (0.7-1.9) .59 0.8 (0.4-1.6)

Poor <.001 3.7 (2.4-5.6) .005 3.7 (1.5-9.1)

IPSS-R IPSS-R score

Low .70 1.1 (0.6-2.3) .79 0.9 (0.4-2.0)

Intermediate <.001 4.4 (2.3-8.5) .56 1.4 (0.4-4.6)

High <.001 5.1 (2.6-10.0) .82 1.2 (0.2-5.8)

Very high <.001 13.2 (6.7-26.3) .67 1.6 (0.19-13.6)

Age >60 y .009 0.6 (0.4-0.9) .49 0.9 (0.6-1.3)

Sex: male .78 1.1 (0.7-1.5) .72 1.1 (0.7-1.6)

Bone marrow blast percentage categories <.001 2.3 (1.9-2.7) <.001 1.9 (1.4-2.8)

Anemia categories .91 0.98 (0.7-1.3) .36 0.8 (0.5-1.3)

Absolute neutrophil count <0.8 x 109/L <.001 2.2 (1.5-3.1) .29 1.3 (0.8-1.9)

Thrombocytopenia categories <.001 2.1 (1.4-3.2) .89 0.9 (0.6-1.7)

Red cell transfusion dependence .59 0.9 (0.6-1.3) .52 0.9 (0.6-1.3)

ECOG performance status

1

2

3

Cytogenetic categories

Good .11 5.0 (0.7-36.3) .08 6.1 (0.8-45.5)

Intermediate .05 7.5 (1.0-55) .09 6.3 (0.8-52.5)

Poor .02 11.5 (1.5-90.7) .07 8.4 (0.9-83.1)

Very poor .002 23.9 (3.2-179.4) .02 15.5 (1.5-161.6)

WPSS WPSS score

Low .23 1.6 (0.7-3.5) .80 0.8 (0.2-3.5)

Intermediate .001 3.6 (1.6-7.5) .96 1.0 (0.2-10.8)

High <.001 6.4 (3.1-13.2) .90 1.2 (0.1-10.8)

Very high <.001 17.2 (7.7-38.2) .68 1.9 (0.1-41.4)

WHO categories

RCMD .003 2.6 (1.4-5.0) .18 2.5 (0.7-9.1)

RAEB-1 <.001 9.8 (4.9-19.2) .01 7.9 (1.5-41)

RAEB-2 <.001 12.5 (6.5-24) .05 7.7 (1.0-57.2)

Cytogenetic categories <.001 1.8 (1.5-2.3) .47 1.2 (0.7-2.2)

Red cell transfusion dependence .59 0.9 (0.6-1.3) .25 0.7 (0.4-1.3)

TABLE 4. Univariable and Multivariable Analyses of Variables Predicting Leukemia-Free Survival in 1000 Patients With Primary Myelodysplastic Syndromes

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MD Anderson MD Anderson score

Intermediate-1 .03 1.7 (1.1-2.8) .41 1.3 (0.7-2.7)

Intermediate-2 <.001 3.5 (2.1-5.9) .48 1.5 (0.5-4.5)

High <.001 9.2 (5.3-16.1) .33 2.3 (0.4-12.2)

Age categories .05 0.8 (0.7-1.0) .72 0.9 (0.7-1.3)

Anemia categories .29 1.2 (0.9-1.5) .55 1.1 (0.8-1.6)

WBC count categories .09 1.8 (0.9-3.7) .94 1.0 (0.5-2.1)

Thrombocytopenia categories <.001 1.4 (1.2-1.7) .88 0.9 (0.7-1.3)

Bone marrow blast percentage categories <.001 3.0 (2.5-3.7) <.001 2.5 (1.9-3.5)

Performance status

1 N/A N/A N/A N/A

2 N/A N/A N/A N/A

3 N/A N/A N/A N/A

Cytogenetic categories <.001 1.5 (1.3-1.8) .08 1.3 (0.9-1.7)

Previous transfusions .59 0.9 (0.6-1.3) .10 0.7 (0.4-1.1)

a ECOG = European Cooperative Oncology Group; FAB = French American British; IPSS = International Prognostic Scoring System; IPSS-R = Revised International Prognostic Scoring System; RAEB-1 = refractory anemia with excess blasts-1; RAEB-2 = refractory anemia with excess blasts-2; RCMD = refractory cytopenia with multilineage dysplasia; WBC = white blood cell; WHO = World Health Organization; WPSS = World Health Organization Prognostic Scoring System.

TABLE 4. Continued