{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T15:51:35Z","timestamp":1783180295847,"version":"3.54.6"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,9,26]],"date-time":"2018-09-26T00:00:00Z","timestamp":1537920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008884","name":"Edward P. Evans Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008884","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 CA016672"],"award-info":[{"award-number":["P30 CA016672"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The International Prognostic Scoring System\u2010Revised (IPSS\u2010R) is one standard for myelodysplastic syndrome (MDS) risk stratification. It divides patients into five categories including an intermediate subset (IPSS\u2010R int\u2010risk). Outcomes and clinical interventions for patients with IPSS\u2010R int\u2010risk are not well defined. We performed an analysis of outcomes of this group of patients. Out of 3167 patients, a total of 298 were identified with IPSS\u2010R int\u2010risk MDS and retrospectively analyzed to assess characteristics affecting outcomes. Cox proportional hazard models for overall survival (OS) were performed to identify statistically significant clinical factors that influence survival. Age of 66 years or greater, peripheral blood blasts of 2% or more, and history of red blood cell (RBC) transfusion were significantly associated with inferior survival. Based on these features, MDS patients with IPSS\u2010R int\u2010risk were classified into two prognostic risk groups for analysis, an int\u2010favorable group and an int\u2010adverse group, and had significantly divergent outcomes. Sequential prognostication was validated using two independent datasets comprising over 700 IPSS\u2010R int\u2010risk patients. The difference in median survival between int\u2010favorable and int\u2010adverse patients was 3.7 years in the test cohort, and 1.8 and 2.0 years in the two validation cohorts. These results confirm significantly variable outcomes of patients with IPSS\u2010R int\u2010risk and need for different prognostic systems.<\/jats:p>","DOI":"10.1002\/ajh.25234","type":"journal-article","created":{"date-parts":[[2018,7,27]],"date-time":"2018-07-27T08:40:44Z","timestamp":1532680844000},"page":"1245-1253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Prognosis of patients with intermediate risk IPSS\u2010R myelodysplastic syndrome indicates variable outcomes and need for models beyond IPSS\u2010R"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3645-148X","authenticated-orcid":false,"given":"Christopher B.","family":"Benton","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4516-3837","authenticated-orcid":false,"given":"Maliha","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sallman","sequence":"additional","affiliation":[{"name":"Department of Malignant Hematology H. Lee Moffitt Cancer Center  Tampa Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziz","family":"Nazha","sequence":"additional","affiliation":[{"name":"Department of Leukemia Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela M.","family":"Nogueras Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Statistics The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Piao","sequence":"additional","affiliation":[{"name":"Department of Statistics The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Statistics The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fleur","family":"Aung","sequence":"additional","affiliation":[{"name":"Laboratory Medicine The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najla","family":"Al Ali","sequence":"additional","affiliation":[{"name":"Department of Malignant Hematology H. Lee Moffitt Cancer Center  Tampa Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4465-6119","authenticated-orcid":false,"given":"Elias","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9892-9832","authenticated-orcid":false,"given":"Tapan M.","family":"Kadia","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7679-6453","authenticated-orcid":false,"given":"Gautam","family":"Borthakur","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Ravandi","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Steensma","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"DeZern","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Center The Johns Hopkins University School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Roboz","sequence":"additional","affiliation":[{"name":"Joan and Sanford I. Weill Department of Medicine Weill Cornell Medical  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkael","family":"Sekeres","sequence":"additional","affiliation":[{"name":"Department of Leukemia Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Andreeff","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1908-3307","authenticated-orcid":false,"given":"Hagop","family":"Kantarjian","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1876-5269","authenticated-orcid":false,"given":"Rami S.","family":"Komrokji","sequence":"additional","affiliation":[{"name":"Department of Malignant Hematology H. 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