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3579 IPSS-M Predicts Survival Outcomes Significantly Better Than IPSS-R in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation for Myelodysplastic Neoplasms

Program: Oral and Poster Abstracts
Session: 723. Allogeneic Transplantation: Long-term Follow-up and Disease Recurrence: Poster II
Hematology Disease Topics & Pathways:
Research, Clinical Research, real-world evidence
Sunday, December 10, 2023, 6:00 PM-8:00 PM

Tingting Yang1*, Bingqian Jiang1*, Yi Luo1, Yanmin Zhao1*, Guifang Ouyang2*, Jian Yu1*, Jianping Lan3*, Ying Lu4*, Xiaoyu Lai1*, Baodong Ye, MD5*, Yi Chen6*, Lizhen Liu1*, Yang Xu7*, Qunyi Guo8*, Pengfei Shi9*, Haowen Xiao10*, Huixian Hu11*, Huarui Fu1*, Yishan Ye, MD1*, Xinyu Wang1*, Jie Sun1*, Weiyan Zheng, MD1*, Jingsong He1*, Yi Zhao1*, Wenjun Wu1*, Zhen Cai1*, Guoqing Wei1*, He Huang1* and Jimin Shi1*

1Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
2Department of Hematology, Ningbo First Hospital, Ningbo, China
3Department of Hematology, Zhejiang Provincial People’s Hospital, Hangzhou, China
4Department of Hematology, Yinzhou People's Hospital, Ningbo, China
5The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
6Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
7The Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China
8Department of Hematology, Taizhou Hospital of Zhejiang Province, Wenzhou Medical College, Taizhou, China
9Department of Hematology, The Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
10Department of Hematology, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine,, Hangzhou, China
11Department of Hematology, Jinhua Central Hospital, Jinhua, China


The newly published molecular International Prognostic Scoring System (IPSS-M) represents a powerful risk stratification tool for treatment decision-making in myelodysplastic neoplasms (MDS); however, its utility in the context of allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains to be fully explored.


We retrospectively analyzed a large multicenter cohort of 347 MDS patients who underwent allo-HSCT between January 2017 and October 2022. The prediction accuracy of IPSS-M at diagnosis for 3-year survival outcomes was assessed and compared to that of the conventional revised International Prognostic Scoring System (IPSS-R).


Among the 347 patients, median age at transplant was 48.3 years and 41.2% of patients were female. According to IPSS-M, patients were clustered as very low risk (1.2%), low risk (11.2%), moderately low risk (11.5%), moderately high risk (18.2%), high risk (33.4%), and very high risk (24.5%), resulting in a restratification of 49.3% of the entire cohort when compared with IPSS-R. Of these reclassified patients, 52.6% patients were upstaged and 47.4% were downstaged. Median follow-up time among the survivors was 28.6 (range, 4.7 to 76.6) months. With the IPSS-M model, overall survival (OS) and leukemia-free survival (LFS) discrimination was refined relative to the IPSS-R as evidenced by a 7.0 percentage- and 5.7 percentage-point increase in the concordance index (C-index), which was further supported by the lower Akaike Information Criterion and higher C-indexes in multivariate analyses. Among patients undergoing haploidentical HSCT, IPSS-M model also demonstrated significantly improved prognostic performance for LFS versus IPSS-R (C-index, 0.707 vs 0.604) which was validated by multivariate analyses. When restricting our analyses to younger patients (<49 years) and patients carrying detectable mutations, IPSS-M retained greater prognostic value with respect to OS and LFS; while it failed to stratify individual probability of OS and LFS in their counterparts.


IPSS-M was confirmed to increase prognostic discrimination at the individual level and is applicable to transplant-specific settings, which also had an advantage for subjects carrying mutations and younger patients.

Disclosures: No relevant conflicts of interest to declare.

*signifies non-member of ASH