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Kuendgen, A; Nomdedeu, M; Tuechler, H; Garcia-Manero, G; Komrokji, RS; Sekeres, MA; Della Porta, MG; Cazzola, M; DeZern, AE; Roboz, GJ; Steensma, DP; Van de Loosdrecht, AA; Schlenk, RF; Grau, J; Calvo, X; Blum, S; Pereira, A; Valent, P; Costa, D; Giagounidis, A; Xicoy, B; Döhner, H; Platzbecker, U; Pedro, C; Lübbert, M; Oiartzabal, I; Díez-Campelo, M; Cedena, MT; Machherndl-Spandl, S; López-Pavía, M; Baldus, CD; Martinez-de-Sola, M; Stauder, R; Merchan, B; List, A; Ganster, C; Schroeder, T; Voso, MT; Pfeilstöcker, M; Sill, H; Hildebrandt, B; Esteve, J; Nomdedeu, B; Cobo, F; Haas, R; Sole, F; Germing, U; Greenberg, PL; Haase, D; Sanz, G.
Therapy-related myelodysplastic syndromes deserve specific diagnostic sub-classification and risk-stratification-an approach to classification of patients with t-MDS.
Leukemia. 2020;
Web of Science PubMed FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Sill Heinz
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Abstract:
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 (both p < 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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