Several predictive scores have been described for patients with myelofibrosis (MF): these include IPSS [1], DIPPS [2], MYSEC [3], MIPSS [4] and GIPSS [5]. All of these have in common the identification of clinical, and biological risk factors for evolution of the disease and death. When these prognostic scores are applied to patients undergoing a hemopoietic stem cell transplant (HSCT), the outcome reflects the progression of the disease: patients with an early disease, always do better than patients with more advanced disease, and/or a higher risk score [6, 7]. The question is the following: can we identify a prognostic score, specifically designed for patients undergoing an allogeneic HSCT. A recent study has identified transplant and molecular characteristics predictive of transplant outcome, and is referred to as the MTSS or molecular and transplant scoring system. These include: age over 57, Karnovsky score < 90%, platelet counts < 150 × 10^9/L, leukocyte count > 25 × 10^9/L, an HLA mismatched donor, ASXL1 mutation, and non-CARL/MP genotype, to be independent predictors of outcome [8], The Authors incorporate these factors in 4 level MTSS, low (0–2), intermediate (3–4), high (5) and very high (>5). The OS at 5 years for these groups was 90% (low), 77% (intermediate), 50% (high) and 34% (very high). However, there is no mention of relapse in this study, and thus one wonders why introduce molecular prognostication.

Sica, S., Predicting the outcome for patients with myelofibrosis undergoing an allogeneic hemopoietic stem cell transplant, <<BLOOD CANCER JOURNAL>>, 2022; 12 (7): 7-12. [doi:10.1038/s41408-022-00701-w] [https://hdl.handle.net/10807/229471]

Predicting the outcome for patients with myelofibrosis undergoing an allogeneic hemopoietic stem cell transplant

Sica, Simona
Secondo
Membro del Collaboration Group
2022

Abstract

Several predictive scores have been described for patients with myelofibrosis (MF): these include IPSS [1], DIPPS [2], MYSEC [3], MIPSS [4] and GIPSS [5]. All of these have in common the identification of clinical, and biological risk factors for evolution of the disease and death. When these prognostic scores are applied to patients undergoing a hemopoietic stem cell transplant (HSCT), the outcome reflects the progression of the disease: patients with an early disease, always do better than patients with more advanced disease, and/or a higher risk score [6, 7]. The question is the following: can we identify a prognostic score, specifically designed for patients undergoing an allogeneic HSCT. A recent study has identified transplant and molecular characteristics predictive of transplant outcome, and is referred to as the MTSS or molecular and transplant scoring system. These include: age over 57, Karnovsky score < 90%, platelet counts < 150 × 10^9/L, leukocyte count > 25 × 10^9/L, an HLA mismatched donor, ASXL1 mutation, and non-CARL/MP genotype, to be independent predictors of outcome [8], The Authors incorporate these factors in 4 level MTSS, low (0–2), intermediate (3–4), high (5) and very high (>5). The OS at 5 years for these groups was 90% (low), 77% (intermediate), 50% (high) and 34% (very high). However, there is no mention of relapse in this study, and thus one wonders why introduce molecular prognostication.
2022
Inglese
Sica, S., Predicting the outcome for patients with myelofibrosis undergoing an allogeneic hemopoietic stem cell transplant, <<BLOOD CANCER JOURNAL>>, 2022; 12 (7): 7-12. [doi:10.1038/s41408-022-00701-w] [https://hdl.handle.net/10807/229471]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/229471
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