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In addition, we used a simple objective exclusion criterion. Other, more sophisticated, exclusion or outlier detection techniques seemed too cumbersome. Each IPSS http://www.selleck.cn/products/gsk-j4-hcl.html Risk group was further subdivided according to blast percentage of its constituent members, and according to the IPSS cytogenetic score. Analysis of the CHF and hypothesis examination was performed on each subgroup similar to the analyses described earlier. To eliminate a possible effect of the, rather, arbitrary IPSS cutoff point, we reiterated all the previous analyses after reclassifying the patients according to the newly updated definition of MDS, so that patients whose BM blast cell percentage exceeded 20% were considered as sAML patients [27]. The total number of patients remaining after this exclusion was 263, 396, 227, and 51 in Low to High risk groups, respectively. Among these, the number of patients who developed sAML was 35, 85, 104, and 30, respectively. http://www.selleckchem.com/products/byl719.html A univariate analysis was carried out for evaluating the influence of individual prognostic factors on the TTA data in the studied patient group (609 men and 410 women; see Methods section). Three prognostic factors were examined: age (higher or lower than the median 66 years), IPSS, and gender. Patients' characteristics and the influence of each prognostic factor on the TTA were summarized (Table I). IPSS was found to be the only prognostic factor with a statistically significant effect on TTA (P value http://www.selleckchem.com/products/BEZ235.html risk, nor does it reflect a single-event hypothesis, for which constant transformation risk is expected (see Methods). A close inspection of the empirical CHF curves reveals that a few patients in each IPSS group had unusually long TTAs, disparate from the bulk of data of their respective risk groups. The inclusion of these patients in the IPSS group led to risk-group heterogeneity, which could obscure the underlying representative CHF, and was the plausible cause of the unexplained decrease in sAML transformation risk (see Discussion). Therefore, we excluded these patients from the dataset. First, we identified candidates for exclusion according to the objective box-plot exclusion criterion. This criterion yielded TTA cutoff points of 108.7, 67.7, 36.4, and 21.1 months for the four Low to High risk groups, respectively.