Hematology · 4 h ago
Adapted IPSS-M stratifies risk in chronic myelomonocytic leukemia
A multicenter retrospective study of 511 patients with chronic myelomonocytic leukemia (CMML) assessed the prognostic performance of IPSS-M and compared it with CMML-specific scoring systems. An adapted four-tier IPSS-M model separated patients by overall survival and acute myeloid leukemia progression risk across myelodysplastic and myeloproliferative CMML subsets.
- Retrospective multicenter cohort included 511 patients with CMML.
- Adapted IPSS-M stratified overall survival and AML progression risk.
- Prognostic performance was retained across CMML disease subsets.
- The study did not test whether score-guided care improves outcomes.
Prognostication in chronic myelomonocytic leukemia (CMML) is complicated by the disease’s biological and clinical variability. In this multicenter retrospective study, researchers evaluated 511 patients using clinical, cytogenetic, and targeted next-generation sequencing data collected at diagnosis. They compared the Molecular International Prognostic Scoring System (IPSS-M) with the CMML-specific CPSS-Mol and international CPSS (iCPSS), assessing overall survival and progression to acute myeloid leukemia (AML).
IPSS-M stratified patients into groups with significantly different overall survival and cumulative incidence of AML progression. After combining overlapping intermediate-risk categories, an adapted four-tier model had a C-index of 0.678 for overall survival and 0.628 for AML progression. Performance was retained in both myelodysplastic and myeloproliferative CMML subsets, with greater overall-survival discrimination in the myelodysplastic subset. The adapted model performed comparably to iCPSS and better than CPSS-Mol in discrimination.
The findings support the prognostic applicability of adapted IPSS-M in CMML and provide external validation of iCPSS in a genetically characterized cohort. The retrospective design and prognostic, rather than treatment-effect, outcomes mean the results do not establish that using the score improves treatment decisions or patient outcomes.
In practice
For clinicians assessing patients with CMML, an adapted four-tier IPSS-M model may help distinguish prognosis for overall survival and AML progression, and its performance was observed in both myelodysplastic and myeloproliferative subsets. In this retrospective, multicenter cohort of 511 patients, discrimination was moderate (C-index 0.678 for overall survival and 0.628 for AML progression). These data support prognostic use but do not show that score-guided treatment changes improve outcomes or establish a preferred management strategy.
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Blood Advances: Assessment of the IPSS-M in chronic myelomonocytic leukemia ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.