The Impact of Blast Percentage on Posttransplant Outcomes of Patients With Myelodysplastic Syndromes: A Retrospective Analysis Within the IPSS-M Framework

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-07-28 DOI:10.1111/ctr.70258

Zhong-Shi Lyu, Yu-Qian Sun, Xiao-Dong Mo, Meng Lv, Yi-Fei Cheng, Lan-Ping Xu, Xiao-Hui Zhang, Xiao-Jun Huang, Yu Wang

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引用次数: 0

Abstract

Background

Blast percentage is crucial for myelodysplastic syndrome (MDS) diagnosis and risk stratification, but its role is now less prominent due to comprehensive genetic-based scoring systems like the Molecular International Prognostic Scoring System (IPSS-M). Originally, blast percentage was an independent categorical variable for prognosis, but in the IPSS-M, it is treated as a continuous variable. We hypothesize that blast percentage should still hold categorical value within genetic-based systems like the IPSS-M, especially for predicting transplant outcomes.

Methods

A total of 225 MDS patients posttransplantation were retrospectively studied for blast percentage and genetic impact.

Results

We identified significant disparities in relapse rates, with a marked contrast between the MDS with increased blasts (IBs) group and the MDS with low blasts group, achieving statistical significance. Intriguingly, within the IB cohort, a pronounced divergence in relapse rates was noted between the high and low risk subgroups within the IB-1 group, but not the IB-2 group. Furthermore, the combined model of blast percentage and IPSS-M demonstrated enhanced prognostic performance, with a higher C-index and lower information criteria than IPSS-M alone, indicating the synergistic prognostic value of these two factors.

Conclusion

Our study underscores the significant value of integrating blast percentage as a categorical variable with the IPSS-M for posttransplant prognosis in MDS patients.

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干细胞百分比对骨髓增生异常综合征患者移植后预后的影响：IPSS-M框架内的回顾性分析

爆炸百分比对于骨髓增生异常综合征（MDS）的诊断和风险分层至关重要，但由于分子国际预后评分系统（IPSS-M）等全面的基于遗传的评分系统，其作用现在不那么突出。最初，爆炸百分率是预后的独立分类变量，但在IPSS-M中，它被视为一个连续变量。我们假设胚率在遗传系统如IPSS-M中仍然具有分类价值，特别是在预测移植结果方面。方法对225例移植后MDS患者的细胞百分率和遗传影响进行回顾性研究。结果我们发现了复发率的显著差异，MDS增加母细胞组（IBs）和MDS低母细胞组对比明显，具有统计学意义。有趣的是，在IB队列中，IB-1组中高风险亚组和低风险亚组之间的复发率存在明显差异，但IB-2组中没有。此外，爆炸百分率和IPSS-M联合模型的预后性能增强，其c指数高于单独IPSS-M，但信息标准较低，表明这两个因素具有协同预后价值。结论我们的研究强调了将母细胞百分比作为一个分类变量与IPSS-M相结合对MDS患者移植后预后的重要价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.