Table 2.

Impact of comorbidities on OS

Study, year (N)Prospective? Comorbidity scale(s)MDS scorePredictive factors for OS/EFS by MVT analysisNovel composite prognostic score derived?Applicability/comments
Bammer et al,74  2014 (616) No, HCT-Cl, CCl IPSS HCT-CI, IPSS, age No HCT-CI scores higher in men than women; more CVD in men 
Sperr et al,76  2013 (400) No, HCT-CI IPSS HCT-CI, ferritin >900, age Yes  
Zipperer et al,30  2008 (171) No, HCT-CI, CCI IPSS HCT-CI, IPSS No Only in int-2 and high risk 
Naqvi et al,25  2011 (600) No, ACE-27 IPSS ACE-27, age, IPSS Yes Only in int-1, int-2, and high-risk disease; patients ≤age 65 
Daver et al,28  2014 (600) No, ACE-27 IPSS-R ACE-27, age, IPSS-R Yes Only in int-, high-, and very high-risk patients of all ages; same cohort from Naqvi et al26  
Della Porta et al,26  2010 (840 derivation and 540 validation) No, MDS-CI, CCI, HCT-CI WPSS MDS-CI, WPSS No Only in WPSS very low-, low-, and intermediate-risk disease 
Balleari et al, 2015 (318) No, MDS-CI, HCT-CI IPSS, IPSS-R MDS-CI, IPSS or IPSS-R, age >75, male No Only in IPSS/IPSS-R int-2/int and high-, very high- risk patients 
van Spronsen et al,29  2014 (222) No, MDS-CI IPSS, MDAS, WPSS, WPSSR, IPSSR MDS-CI, IPSS-R, age, PS, fibrosis transfusions No Other MDS scoring systems were valid, but IPSS-R was best 
Zipperer et al,30  2014 (1161) No, MDS-CI IPSS-R MDS-CI, IPSS-R No Only when combined very low/low and intermediate-/high-/very high-risk 
Breccia et al,77  2012 (418) No, MDS-CI, CCI, HCT-CI WPSS CCI or MDS-CI, age >60, Hgb <8, Plt <50, bleeding No Higher MDS-CI and CCI scores associated with RBC transfusion dependency 
Falantes et al,75  2016 (232) No, MDS-CI IPSS-R, IPSS MDS-CI, age >75 y, diabetes on Tx, Hgb <10 Yes Focus on NLD; patient population restricted to IPSS-low and int 
Buckstein et al,69  2016 (445) Yes, MDS-CI, CCI, HCT-CI IPSS-R, IPSS CCI frailty, IPSS Yes In separate models, MDS-CI was also prognostic, but the model with CCI had the largest R2; frailty refined prognosis in all but IPSS-R very high risk 
Study, year (N)Prospective? Comorbidity scale(s)MDS scorePredictive factors for OS/EFS by MVT analysisNovel composite prognostic score derived?Applicability/comments
Bammer et al,74  2014 (616) No, HCT-Cl, CCl IPSS HCT-CI, IPSS, age No HCT-CI scores higher in men than women; more CVD in men 
Sperr et al,76  2013 (400) No, HCT-CI IPSS HCT-CI, ferritin >900, age Yes  
Zipperer et al,30  2008 (171) No, HCT-CI, CCI IPSS HCT-CI, IPSS No Only in int-2 and high risk 
Naqvi et al,25  2011 (600) No, ACE-27 IPSS ACE-27, age, IPSS Yes Only in int-1, int-2, and high-risk disease; patients ≤age 65 
Daver et al,28  2014 (600) No, ACE-27 IPSS-R ACE-27, age, IPSS-R Yes Only in int-, high-, and very high-risk patients of all ages; same cohort from Naqvi et al26  
Della Porta et al,26  2010 (840 derivation and 540 validation) No, MDS-CI, CCI, HCT-CI WPSS MDS-CI, WPSS No Only in WPSS very low-, low-, and intermediate-risk disease 
Balleari et al, 2015 (318) No, MDS-CI, HCT-CI IPSS, IPSS-R MDS-CI, IPSS or IPSS-R, age >75, male No Only in IPSS/IPSS-R int-2/int and high-, very high- risk patients 
van Spronsen et al,29  2014 (222) No, MDS-CI IPSS, MDAS, WPSS, WPSSR, IPSSR MDS-CI, IPSS-R, age, PS, fibrosis transfusions No Other MDS scoring systems were valid, but IPSS-R was best 
Zipperer et al,30  2014 (1161) No, MDS-CI IPSS-R MDS-CI, IPSS-R No Only when combined very low/low and intermediate-/high-/very high-risk 
Breccia et al,77  2012 (418) No, MDS-CI, CCI, HCT-CI WPSS CCI or MDS-CI, age >60, Hgb <8, Plt <50, bleeding No Higher MDS-CI and CCI scores associated with RBC transfusion dependency 
Falantes et al,75  2016 (232) No, MDS-CI IPSS-R, IPSS MDS-CI, age >75 y, diabetes on Tx, Hgb <10 Yes Focus on NLD; patient population restricted to IPSS-low and int 
Buckstein et al,69  2016 (445) Yes, MDS-CI, CCI, HCT-CI IPSS-R, IPSS CCI frailty, IPSS Yes In separate models, MDS-CI was also prognostic, but the model with CCI had the largest R2; frailty refined prognosis in all but IPSS-R very high risk 

CVD, cardiovascular disease; EFS, event-free survival; Hgb, hemoglobin; MVT, multivariate testing; NLD, nonleukemic death; Plt, platelet; PS, performance status; RBC, red blood cell; Tx, treatment.

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