Relevant metrics: how significant CCUS truly is

In this issue of Blood, Galli and colleagues provide a sophisticated description of the genotypic and phenotypic features of patients with idiopathic cytopenia of undetermined significance (ICUS) and clonal cytopenia of undetermined significance (CCUS). CCUS is associated with an increased risk of progression to myeloid neoplasm (MN) associated with myelodysplasia (MDS), but an individual's rate of progression is highly variable. In their large, closely followed cohort, the authors demonstrate 3 major variables that predict outcome: the number of mutations, the types of mutations, and variant allele frequencies (VAFs) of those mutations.(1) They drew clinical comparisons to patients with overt MN as well as a control group of older control patients, with and without anemia, to better characterize the clonal metrics. This study addresses a common problem in clinical practice: how to best advise cytopenic patients of their risk of transformation to overt MN based on their molecular mutational profile.

Automated summary

The study provides a sophisticated description of patients with idiopathic cytopenia of undetermined significance (ICUS) and clonal cytopenia of undetermined significance (CCUS) by identifying three main predictive variables for outcomes. Clinical comparisons were made with overt MN patients and older control patients to better characterize the clonal metrics. The research aims to help clinicians advise cytopenic patients on their risk of transformation to overt MN based on their molecular mutational profile.