Telomere integrated scoring system of myelodysplastic syndrome

J Clin Lab Anal. 2023 Feb;37(3):e24839. doi: 10.1002/jcla.24839. Epub 2023 Jan 19.

Abstract

Introduction: Recently, multigene target sequencing is widely performed for the purpose of prognostic prediction and application of targeted therapy. Here, we proposed a new scoring system that encompasses gene variations, telomere length, and Revised International Prognostic Scoring System (IPSS-R) together in Asian myelodysplastic syndrome.

Methods: We developed a new scoring model of these variables: age ≥ 65 years + IPSS-R score + ASXL1 mutation + TP53 mutation + Telomere length (<5.37). According to this new scoring system, patients were divided into four groups: very good score cutoff (≤3.0), good (3.0-4.5), poor (4.5-7.0), and very poor (>7.0).

Results: The median OS was 170.1, 100.4, 46.0, and 12.0 months for very good, good, poor, and very poor, retrospectively (p < 0.001). Meanwhile, according to the conventional IPSS-R scoring system, the median OS was 141.3, 50.2, 93.0, 36.0, and 16.2 months for very low, low, intermediate, high, and very high, retrospectively (p < 0.001).

Conclusions: The newly developed model incorporating molecular variations and TL yielded more clear separations of the survival curves. By adding the presence of gene mutation and telomere length to the existing IPSS-R, its predictive ability can be further improved in myelodysplastic syndrome.

Keywords: Revised International Prognostic Scoring System; myelodysplastic syndrome; targeted capture sequencing; telomere length.

MeSH terms

  • Aged
  • Humans
  • Mutation
  • Myelodysplastic Syndromes*
  • Prognosis
  • Retrospective Studies
  • Telomere