Table 5. Indication for allogeneic stem cell transplantation in myelodysplastic syndrome*.
| Risk (IPSS score) | Indication for allogeneic SCT | ||||
|---|---|---|---|---|---|
| Low (0) | None | ||||
| Intermediate-1 (0.5 or 1) | In special cases: high-risk cytogenetics or severe cytopenias | ||||
| Intermediate-2 (1.5 or 2) | Standard | ||||
| High (2.5 to 3.5) | Standard | ||||
| IPSS | |||||
| Variable | Score | ||||
| 0 | 0.5 | 1 | 1.5 | 2 | |
| BM blasts Cytogenetics Cytopenia |
<5 Good 0 or 1 |
5–10 Intermediate 2 or 3 |
Poor | 11–20 | 21–30 |
| Cytogenetics | Good Intermediate Poor |
Normal. only del(5q). only del(20q). only –Y All others Complex with >2 aberrations; anomalies of chromosome 7 |
|||
*The indication for allogeneic SCT is based on models for estimation of the risk of transformation into AML. To date the IPSS has been used. but the IPSS-R will offer an improved system in future.
IPSS. International Prognostic Scoring System; BM. bone marrow; SCT. stem cell transplantation