期刊
LEUKEMIA
卷 35, 期 3, 页码 835-849出版社
SPRINGERNATURE
DOI: 10.1038/s41375-020-0917-7
关键词
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资金
- AIRC 5 x 1000 call Metastatic disease: the key unmet need in oncology [21267]
- Austrian Science Fund [F4704-B20]
- Projekt DEAL
The study shows that therapy-related myelodysplastic syndromes (t-MDS) are as heterogeneous as primary MDS, and require the same careful differentiation regarding risk. Despite less favorable clinical outcomes in t-MDS subsets compared to primary MDS, classification and prognostic scoring effectively separated t-MDS patients into different risk groups.
In the current World Health Organization (WHO)-classification, therapy-related myelodysplastic syndromes (t-MDS) are categorized together with therapy-related acute myeloid leukemia (AML) and t-myelodysplastic/myeloproliferative neoplasms into one subgroup independent of morphologic or prognostic features. Analyzing data of 2087 t-MDS patients from different international MDS groups to evaluate classification and prognostication tools we found that applying the WHO classification for p-MDS successfully predicts time to transformation and survival (bothp < 0.001). The results regarding carefully reviewed cytogenetic data, classifications, and prognostic scores confirmed that t-MDS are similarly heterogeneous as p-MDS and therefore deserve the same careful differentiation regarding risk. As reference, these results were compared with 4593 primary MDS (p-MDS) patients represented in the International Working Group for Prognosis in MDS database (IWG-PM). Although a less favorable clinical outcome occurred in each t-MDS subset compared with p-MDS subgroups, FAB and WHO-classification, IPSS-R, and WPSS-R separated t-MDS patients into differing risk groups effectively, indicating that all established risk factors for p-MDS maintained relevance in t-MDS, with cytogenetic features having enhanced predictive power. These data strongly argue to classify t-MDS as a separate entity distinct from other WHO-classified t-myeloid neoplasms, which would enhance treatment decisions and facilitate the inclusion of t-MDS patients into clinical studies.
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