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Years (com Transplantation

Figure 42.1 Impact of IPSS score on outcome. The + indicates censored patient; in 7 patients, an IPSS score could not be assigned. (a) Relapse-free survival. (b) CI of relapse. (Reprinted from Ref. 8, used with permission.)

which are important independent adverse factors,14 it is likely to be a more robust system to predict outcome following an allogeneic SCT.

IPSS score also has an important bearing on decision making with regards to proceeding with an allogeneic stem cell transplant. In the low-risk group with a median survival of 11.8 years in patients younger than 60 years,6 one would opt for supportive care or a nonintensive low-risk therapy rather than subject such an individual to the risk of treatment-related mortality (TRM) following an allogeneic SCT. On the other hand, a patient with an IPSS score >2, who has a median survival of a few months6, is a candidate for an allogeneic SCT provided a donor is available and his or her performance status permits the procedure to be done.

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