(ChemotherapyAdvisor) – A new comprehensive cytogenetic scoring system can explicitly classify 91% of all patients with primary myelodysplastic syndromes (MDS), a study published in the Journal of Clinical Oncology online February 13 concluded.

The investigators examined an international data collection of 2,902 patients with primary MDS and oligoblastic acute myeloid leukemia (AML) after MDS who were treated with supportive care alone. Overall survival and AML evolution were evaluated, and 19 cytogenetic categories were defined that provided clear prognostic classification in 91% of all patients. Abnormalities were classified into five prognostic subgroups: very good (median OS, 61 months), good (49 months; reference category), intermediate (26 months), poor (16 months), and very poor (6 months).

The system, which the authors noted should be viewed as a “dynamic model, open to further refinement,” should contribute to ongoing efforts to update the International Prognostic Scoring System (IPSS), implemented in 1997, by refining cytogenetic risk categories.

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An accompanying editorial notes that “without question, this new cytogenetic scoring system will become the standard bearer for classifying the risk of karyotypic abnormalities in MDS.” However, “these schemas are derived from patients with primary, untreated MDS, and thus may not be applicable to patients who have received disease-modifying therapy or who have undergone karyotypic evolution in the course of their disease.” For patients with established disease, “a dynamic, comprehensive cytogenetic scoring scheme” is awaited.