| Background and objective: As the relation between MDS and patients’ prognosis features is getting clearer, the score evaluation of this disease has been playing a vital importance role. IPSS,IPSS-R,WPSS and MDACC are four most usually used scoring systems. But the number of research in comparing these four systems in evaluating MDS prognosis at home is relatively small. The purpose of the present study was to explore the relevance of the prognosis assessment and the clinical application value among IPSS,IPSS-R,WPSS and MDACC in myelodysplastic syndrome.Methods: Two hundred and eighty-seven patients were enrolled in this study.164 patients were male, 123 patients were female. Male to female was 1.3:1.The median age was 53 years(14~81 years). We retrospectively analyzed the basic clinical data of all patients and type the myelodysplastic syndrome according to the WHO classification criteria. Then score again by using IPSS,IPSS-R,WPSS and MDACC, respectively. Analysis of the relevance of the prognosis assessment and the clinical application value among IPSS,IPSS-R,WPSS and MDACC in myelodysplastic syndrome was done. All the data were analyzed by SPSS17.0 statistical software. P<0.05 was considered to have statistically significant.Results: Of all the 287 patients,male 164,female 123,ratio is 1.3:1.78 patients were ≥60 years old,209 patients were <60 years old.Median age was 53 years old(14~81).OS between this two groups was significantly different(P=0.001). Thirty-seven patients detected LDH in this study, with a median of 250 U/L(128~2548 U/L). Eighteen cases were more than 225 U/L and 19 cases were no more than 225 U/L.OS between the two groups had statistical significance(P=0.624).12 patients had β2-MG detection, with a median of 2.67 μg/L(1.35~108 μg/L). The OS between β2-MG > 1.8 μg/L group and β2-MG≤1.8 μg/L was statistically significant(P=0.991). 3. Of 287 MDS patients, 191 cases were normal in chromosome examination. Ninety-six patients had abnormal chromosome karyotype, mostly +8(32 cases), followed by 20q-.We divided them into normal group, the complexed karyotype group and non-complexed karyotype group. The OS between them was statistically significant(P=0.001). 4. We marked the 287 primary MDS patients with application of IPSS, IPSS-R, WPSS and MDACC. Results showed that the four prognostic scoring systems were all able to make accurate judgment of OS(P<0.0001). 5. The correlation comparison between the four systems: IPSS, IPSS-R, WPSS and MDACC have certain correlations, but through the comparison of the survival curve, IPSS and IPSS-R seemed to be the best in determining the prognosis survival of the primary MDS and had more clinical value. 6. We reassess Int-1 patients by in IPSS and high-risk group in IPSS-R and WPSS and found that the new grouping can distinguish some high-risk group patients and the OS was much better when using high-risk treatment therapy(P=0.001).Conclusions: 1. MDS patients who were >60 years old have poorer prognosis.The OS of β2-MG >1.8 μg/L group is less than β2-MG ≤1.8 μg/L group. β2-MG may be used in analysing prognosis of MDS patients and conditioning monitoring. MDS patients whose LDH were above 225 U/L had a shorter survival comparing with those no more than 225 U/L. 2. To some extent, IPSS,IPSS-R,WPSS and MDACC can all be used for evaluating the prognosis of patients with MDS. IPSS-R is of vital importance in guiding clinical treatment. But they all have advantages and disadvantages. IPSS has the highest sensitivity. IPSS-R and WPSS has the strongest correlation. It’ll be better if we combine these scoring systems when evaluating the prognosis of patients. 3. Patients in Int-1 of IPSS can be grouped to higher risk group of IPSS-R and WPSS. These patients can prolong their life by using high-risk treatment therapy. |
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