Contribution of β-2 microglobulin levels to the prognostic stratification of survival in patients with myelodysplastic syndrome (MDS)

Gatto, Simona; Ball, Greg; Onida, Francesco; Kantarjian, Hagop M.; Estey, Elihu H.; Beran, Miloslav

doi:10.1182/blood-2002-10-3264

Cited by 39 publications

(17 citation statements)

References 17 publications

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“…b2-Microglobulin was also associated with a poor prognosis, an observation previously reported. 15 Of note, CMML morphology in these patients with lower risk disease was not associated with worse prognosis, indicating a difference between this group of patients with lower risk CMML and those with more proliferative higher risk disease. There are several limitations to this study.…”

Section: Prognostic Model Of Lower Risk Mds G Garcia-manero Et Almentioning

confidence: 99%

A prognostic score for patients with lower risk myelodysplastic syndrome

et al. 2007

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Current prognostic models for myelodysplastic syndromes (MDS) do not allow the identification of patients with lower risk disease and poor prognosis that may benefit from early therapeutic intervention. We evaluated the characteristics of 856 patients with low or intermediate-1 disease by the International Prognostic Scoring System. Mean follow-up was 19.6 months (range 1-262). Of these patients, 87 (10%) transformed to acute myelogenous leukemia, and 429 (50%) had died. By multivariate analysis, characteristics associated with worse survival (Po0.01) were low platelets, anemia, older age, higher percent of marrow blasts and poor-risk cytogenetics. Although not included in the model, higher ferritin (P ¼ 0.007) and b2-microglobulin (Po0.001) levels were associated with worse prognosis. This allowed the development of a scoring system in which patients could be grouped in three categories: category 1 (n ¼ 182, 21%) with a median survival of 80.3 months (95% CI 68-NA); category 2 (n ¼ 408, 48%) with a median survival of 26.6 months (95% CI 22-32) and category 3 (n ¼ 265, 31%) with a median survival of 14.2 months (95% CI 13-18). In summary, this analysis indicates that it is possible to identify patients with lower risk MDS and poor prognosis who may benefit from early intervention.

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Section: Prognostic Model Of Lower Risk Mds G Garcia-manero Et Almentioning

confidence: 99%

A prognostic score for patients with lower risk myelodysplastic syndrome

et al. 2007

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“…Importantly, recent newer cytogenetic groupings are reported to be prognostically valuable and to refine those features used in the IPSS. 8 Additional variables suggested as providing prognostic information in MDS included serum lactate dehydrogenase (LDH), [9][10][11] ferritin, 12 and ␤ 2 -microglobulin 13,14 as well as marrow fibrosis [15][16][17] and patient comorbidities and performance status. 5,[18][19][20] To examine the prognostic impact of these new clinical and cytogenetic variables and attempt to refine the IPSS, coordination of investigators and coalescence of MDS databases from multiple international institutions provided a much larger combined database of patients by the International Working Group for Prognosis in MDS (IWG-PM) project.…”

Section: Introductionmentioning

confidence: 99%

Revised International Prognostic Scoring System for Myelodysplastic Syndromes

Greenberg

Tuechler

Schanz

et al. 2012

Blood

2,792

2,476

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AbstractThe International Prognostic Scoring Sytem (IPSS) is an important standard for ssessing prognosis of primary untreated adult patients with myelodysplastic syndromes (MDS). To refine the IPSS, MDS patient databases from international institutions were coalesced to assemble a much larger combined database (Revised-IPSS [IPSS-R], n = 7012, IPSS, n = 816) for analysis. Multiple statistically weighted clinical features were used to generate a prognostic categorization model. Bone marrow cytogenetics, marrow blast percentage, and cytopenias remained the basis of the new system. Novel components of the current analysis included: 5 rather than 3 cytogenetic prognostic subgroups with specific and new classifications of a number of less common cytogenetic subsets, splitting the low marrow blast percentage value, and depth of cytopenias. This model defined 5 rather than the 4 major prognostic categories that are present in the IPSS. Patient age, performance status, serum ferritin, and lactate dehydrogenase were significant additive features for survival but not for acute myeloid leukemia transformation. This system comprehensively integrated the numerous known clinical features into a method analyzing MDS patient prognosis more precisely than the initial IPSS. As such, this IPSS-R should prove beneficial for predicting the clinical outcomes of untreated MDS patients and aiding design and analysis of clinical trials in this disease.

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“…Elevated serum h2M levels are reported to predict poor survival in several hematologic malignancies, which include multiple myeloma (11), low-grade lymphomas (12), large-cell lymphomas (13 -15), Hodgkin's lymphoma (16,17), acute lymphoblastic leukemia (18), Philadelphia chromosome -positive chronic myeloid leukemia (19), chronic lymphocytic leukemia (20,21), and myelodysplastic syndromes (22,23).…”

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confidence: 99%

The Prognostic Significance of Serum β2 Microglobulin Levels in Acute Myeloid Leukemia and Prognostic Scores Predicting Survival: Analysis of 1,180 Patients

Tsimberidou¹,

Kantarjian²,

Wen

et al. 2008

Clinical Cancer Research

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Purpose: Serum h 2 microglobulin (h2M) is prognostic in other hematologic malignancies; therefore, we evaluated its prognostic significance in acute myeloid leukemia (AML). Experimental Design: Multivariate analyses were used to examine the effect of pretreatment serum h2M levels on clinical outcomes in patients with AML. h2M was associated with poorer survival in older but not younger patients. We thus fit separate Cox survival models in patients above and below age 60 years treated with remission induction therapy containing high-dose cytarabine (n = 1,280). In each age group, 50% of the patients were used to develop the model, which was tested in the other 50%. Resampling methods were also used to validate the independent prognostic significance of covariates. Results: In patients 60 years or older (n = 591), poorer risk cytogenetics; poorer performance status; and higher levels of h2M, uric acid, and lactate dehydrogenase were each found to independently predict shorter survival and formed the basis of a scoring system. A similar approach was used in patients younger than 60 years (n = 589), with poorer risk cytogenetics, poorer performance status, older age, higher hemoglobin level, and higher leukocyte count predicting a shorter survival and forming the basis of the scoring system. Higher h2M levels were an adverse independent factor for response, survival, relapse-free survival, and event-free survival in older but not in younger patients. Conclusions: Serum h2M levels can help predict outcome in patients z60 years with untreated AML, and their use is strongly encouraged.

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Contribution of β-2 microglobulin levels to the prognostic stratification of survival in patients with myelodysplastic syndrome (MDS)

Cited by 39 publications

References 17 publications

A prognostic score for patients with lower risk myelodysplastic syndrome

A prognostic score for patients with lower risk myelodysplastic syndrome

Revised International Prognostic Scoring System for Myelodysplastic Syndromes

The Prognostic Significance of Serum β2 Microglobulin Levels in Acute Myeloid Leukemia and Prognostic Scores Predicting Survival: Analysis of 1,180 Patients

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