Journal
CANCER JOURNAL
Volume 29, Issue 3, Pages 138-142Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PPO.0000000000000654
Keywords
Clonal dynamics; cytogenetics; h-MDS; IPSS; IPSS-M; IPSS-R; myelodysplastic syndromes; mutations; risk stratification; t-MDS
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Risk stratification is crucial for treatment planning in myelodysplastic syndromes. The traditional International Prognostic Scoring System and its revised version rely on laboratory and cytogenetic data to estimate prognosis and guide treatment. However, advancements in DNA sequencing techniques and understanding of clonal dynamics have allowed the identification of molecular markers that were not accounted for in older models. The Molecular International Prognostic Scoring System integrates clinical, cytogenetic, and molecular data to create a more accurate prognostic tool.
Risk stratification plays an essential role in treatment planning in myelodysplastic syndromes. For decades, the International Prognostic Scoring System and its revised version have provided unified consensus for clinical trial enrollment and design. These models relied on laboratory and cytogenetic data to estimate prognosis and dictate treatment paradigms. Critical developments in DNA sequencing techniques in recent years, as well as our growing understanding of the clonal dynamics of myelodysplastic syndromes and the role that specific mutations have in shaping disease-specific phenotypes and treatment susceptibilities, have made it possible to identify molecular markers that carry critical diagnostic and therapeutic relevance and remained unaccounted for in the older models. The Molecular International Prognostic Scoring System is a novel risk stratification model that integrates clinical, cytogenetic, and molecular data to devise a more refined prognostic tool that builds on the accuracy of the traditional models.
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