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MYELODYSPLASTIC NEOPLASM

Impact of discordant revised versus molecular international prognostic scoring system risk in myelodysplastic syndrome

Leukemia (2025)Cite this article

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TO THE EDITOR:

Myelodysplastic syndromes (MDS) are hematopoietic stem cell (HSC) neoplasms that arise through a stepwise evolutionary process due to the expansion of clonal HSCs [1, 2]. The Revised International Prognostic Scoring System (IPSS-R), based on clinical and pathologic characteristics, has long been the standard risk stratification system used in clinical trials and practice [3]. Recent efforts have integrated genomic data within the Molecular International Prognostic Scoring System (IPSS-M) [4]. Compared to the IPSS-R, the IPSS-M results in a change in risk category in a significant number of patients, with major clinical implications. Indeed, the classification of a patient as either higher risk (HR) or lower risk (LR) is fundamental in the management of MDS, with widely differing treatment approaches. In this study, we evaluated a large cohort of patients with MDS and compared the characteristics and clinical behavior of patients who experienced a change in overall risk (HR versus LR) when re-stratified from IPSS-R to IPSS-M.

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Fig. 1: Risk stratification and baseline clinical/genetic patient characteristics.
Fig. 2: Time-to-event endpoints.

Data availability

The data are not publicly available in order to protect patient confidentiality. Reasonable requests for de-identified data should be directed to the corresponding author.

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Acknowledgements

This work was supported in part by the University of Texas MD Anderson Cancer Center Support Grant CA016672 and the University of Texas MD Anderson MDS/AML Moon Shot.

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Authors and Affiliations

  1. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Alexandre Bazinet, Guillermo Montalban-Bravo, Alex Bataller, Danielle Hammond, Kelly Chien, Koji Sasaki, Ian Bouligny, Mahesh Swaminathan, Wei Ying Jen, Tapan Kadia, Courtney DiNardo, Elias Jabbour, Nicholas Short, Naval Daver, Farhad Ravandi & Guillermo Garcia-Manero

  2. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Sanam Loghavi

  3. Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Uday Popat

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  1. Alexandre Bazinet
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  2. Guillermo Montalban-Bravo
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Contributions

ABazinet designed the study, collected the data, analyzed the data, performed the statistical analyses, generated the figures, and wrote the manuscript. GMB designed the study, critically reviewed the manuscript, and provided feedback/editing. ABataller collected the data, performed the statistical analyses, and generated the figures. DH designed the study, critically reviewed the manuscript, and provided feedback/editing. SL provided the genetic data, critically reviewed the manuscript, and provided feedback/editing. KC collected the data, critically reviewed the manuscript, and provided feedback/editing. KS collected the data, critically reviewed the manuscript, and provided feedback/editing. IB collected the data, critically reviewed the manuscript, and provided feedback/editing. MS collected the data, critically reviewed the manuscript, and provided feedback/editing. WYJ collected the data, critically reviewed the manuscript, and provided feedback/editing. GGM designed the study, provided resources, critically reviewed the manuscript, and provided feedback/editing. UP provided data, critically reviewed the manuscript, and provided feedback/editing. TK, CD, EJ, NS, ND, and FR critically reviewed the manuscript and provided feedback/editing.

Corresponding author

Correspondence to Alexandre Bazinet.

Ethics declarations

Competing interests

GM-B declares research funding from IFM Therapeutics, Rigel Pharmaceuticals, Jazz Pharmaceuticals, Daichii Sankyo, Stemline Therapeutics, and Salarius Pharmaceuticals. SL declares research support from Amgen and Astellas and consulting fees from AbbVie, AlphaSight, Arima, Blueprint Medicine, BMS, Caris, Daiichi-Sankyo, Gerson Lehrman Group, Guide Point, Immunogen, Kura Oncology, QualWorld, Recordati, Servier, Stemline Syndax, Tempus AI. KS declares honoraria from Otsuka Pharma, and consultancy fee from Pfizer Japan. TK declares grants from BMS, AbbVie, Amgen, Ascentage Pharma Group, Astellas Pharma, DrenBio, Astex, AstraZeneca, BMS, Celgene, Incyte, Cellenkos, Cyclacel, Delta-Fly Pharma, Genentech, Genfleet, Glycomimetics, Iterion, Janssen, Jazz Pharmaceuticals, Pfizer, Pulmotect, Regeneron, and SELLAS; consulting fees from AbbVie, Agios, Daiichi Sankyo, Genentech, Genzyme, Jazz Pharmaceuticals, Liberum, Novartis, Pfizer, PinotBio, Pulmotect, Sanofi-Aventis, and Servier; payment/honoraria from AbbVie, Agios, Daiichi Sankyo, DAVA Oncology, Delta-Fly, DrenBio, Genentech, Genfleet, Genzyme, Jazz Pharmaceuticals, Liberum, Novartis, Pfizer, Rigel, Sanofi-Aventis, SELLAS, and Servier. CD declares grants from AbbVie, Astex, ImmuneOnc, BMS, Cleave, Foghorn, Loxo, Rigel, and Servier; consulting fees from Amgen, AbbVie, Astellas, BMS, Genmab, GSK, Gilead, Jazz, Shrodinger, Servier, and Stemline; payment/honoraria from AbbVie, Astellas, BMS, Jazz, and Servier; travel support from Servier; participation on data safety board for Genmab. EJ declares research funding from Amgen, Pfizer, Abbvie, Adaptive Biotechnologies, Astex, Ascentage, and consulting fees from Amgen, Pfizer, Abbvie, Takeda, Adaptive Biotechnologies, Astex, Ascentage, Genentech, Novartis, BMS, Jazz Pharmaceuticals, Hikma Pharmaceuticals, Incyte. NS reports research funding from Astellas Pharma, Stemline Therapeutics, Xencor, Takeda Oncology, consulting fees from Pfizer, Jazz Pharmaceuticals, payment/honoraria from Pfizer, Novartis, Astellas Pharma, Amgen. ND declares grants from Daiichi-Sankyo, BMS, Pfizer, Gilead, Servier, Genentech, Astellas, AbbVie, ImmunoGen, Amgen, Trillium, Hanmi, Trovagene, FATE Therapeutics, Novimmune, Glycomimetics, and KITE; and consulting fees from Daiichi-Sankyo, BMS, Pfizer, Gilead, Servier, Genentech, Astellas, AbbVie, ImmunoGen, Amgen, Trillium, Arog, Novartis, Jazz, Celgene, Syndax, Shattuck Labs, Agios, KITE, and Stemline/Menarini. FR declares research funding from Astex and Taiho Oncology; consultancy from BMS, Abbvie. GG-M declares grants from Astex, Novartis, AbbVie, Genentech, Aprea, Curis, and Gilead; consulting fees from Astex, Acceleron, and BMS; payment/honoraria from Astex, Acceleron, AbbVie, Gilead, Curis, Genentech, and BMS. The remaining authors declare no competing interests.

Ethics approval and consent to participate

All methods were performed in accordance to the relevant guidelines and regulations. Ethics approval for this study was obtained by the University of Texas MD Anderson Cancer Center IRB (file number 2024-0128). Informed consent was waived due to the non-interventional, retrospective nature of this study.

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Bazinet, A., Montalban-Bravo, G., Bataller, A. et al. Impact of discordant revised versus molecular international prognostic scoring system risk in myelodysplastic syndrome. Leukemia (2025). https://doi.org/10.1038/s41375-025-02760-x

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