Therapy-related myelodysplastic syndromes deserve specific diagnostic sub-classification and risk-stratification-an approach to classification of patients with t-MDS
Por:
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, Dohner, H, Platzbecker, U, Pedro, C, Lubbert, M, Oiartzabal, I, Diez-Campelo, M, Cedena, MT, Machherndl-Spandl, S, Lopez-Pavia, M, Baldus, CD, Martinez-de-Sola, M, Stauder, R, Merchan, B, List, A, Ganster, C, Schroeder, T, Voso, MT, Pfeilstocker, M, Sill, H, Hildebrandt, B, Esteve, J, Nomdedeu, B, Cobo, F, Haas, R, Francesc Solé, Germing, U, Greenberg, PL, Haase, D and Sanz, G
Publicada:
1 mar 2021
Ahead of Print:
1 jun 2020
Resumen:
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.
Filiaciones:
Kuendgen, A:
Univ Hosp Duesseldorf, Dept Hematol Oncol & Clin Immunol, Dusseldorf, Germany
Nomdedeu, M:
Inst Catala Oncol Hosp GermansTrias I Pujol, Dept Lab Hematol, Badalona, Spain
Tuechler, H:
Hanusch Hosp, Boltzmann Inst Leukemia Res, Vienna, Austria
Garcia-Manero, G:
MD Anderson Canc Ctr, Dept Leukemia, Houston, TX USA
Komrokji, RS:
H Lee Moffitt Canc Ctr & Res Inst, Dept Malignant Hematol, Tampa, FL USA
Sekeres, MA:
Cleveland Clin, Dept Hematol & Med Oncol, Taussig Canc Inst, Leukemia Program, Cleveland, OH 44106 USA
Della Porta, MG:
IRCCS Humanitas Res Hosp, Canc Ctr, Rozzano Milan, Italy
Humanitas Univ, Rozzano Milan, Italy
Cazzola, M:
IRCCS Policlin San Matteo Fdn, Dept Hematol Oncol, Pavia, Italy
DeZern, AE:
Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD USA
Roboz, GJ:
Weill Cornell Med, New York, NY USA
New York Presbyterian Hosp, New York, NY USA
Steensma, DP:
Dana Farber Canc Inst, Boston, MA 02115 USA
Van de Loosdrecht, AA:
Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
Schlenk, RF:
Univ Hosp Ulm, Dept Internal Med 3, Ulm, Germany
German Canc Res Ctr, Natl Ctr Tumor Dis, Trial Ctr, Heidelberg, Germany
Heidelberg Univ Hosp, Dept Internal Med 5, Heidelberg, Germany
:
Inst Catala Oncol Hosp GermansTrias I Pujol, Dept Lab Hematol, Badalona, Spain
Calvo, X:
IMIM Hosp del Mar Res Inst, Hematol Citol Lab, Pathol Dept, Hosp del Mar,GRETNHE, Barcelona, Spain
Blum, S:
Univ Hosp Lausanne, Serv Hematol, Lausanne, Switzerland
Pereira, A:
Hosp Clin Barcelona IDIBAPS, Hemotherapy & Hemostasis Dept, Barcelona, Spain
Valent, P:
Med Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol, Vienna, Austria
Med Univ Vienna, Ludwig Boltzmann Inst Hematol & Oncol, Vienna, Austria
Costa, D:
Hosp Clin Barcelona IDIBAPS, Hematopathol Sect, Barcelona, Spain
Giagounidis, A:
Marienhosp Duesseldorf, Dept Oncol Hematol & Palliat Care, Dusseldorf, Germany
:
Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol, Clin Hematol Dept, Badalona, Spain
Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, Bellaterra, Spain
Dohner, H:
Univ Hosp Ulm, Dept Internal Med 3, Ulm, Germany
Platzbecker, U:
Univ Hosp Leipzig, Leipzig, Germany
Pedro, C:
Hosp del Mar, Clin Hematol Dept, Barcelona, Spain
Lubbert, M:
Univ Med Ctr Freiburg, Fac Med, Dept Hematol Oncol & Stem Cell Transplantat, Freiburg, Germany
Oiartzabal, I:
Hosp Univ Araba, Clin Hematol Dept, Vitoria, Spain
Diez-Campelo, M:
Hosp Univ Salamanca HUSA, Clin Hematol Dept, Salamanca, Spain
Cedena, MT:
Hosp Univ 12 Octubre, Clin Hematol Dept, Madrid, Spain
Machherndl-Spandl, S:
Elisabethinen Hosp, Internal Dept Hematol Stem Cell Transplants Hemos, Linz, Austria
Lopez-Pavia, M:
Hosp Gen Univ Valencia, Clin Hematol Dept, Valencia, Spain
Baldus, CD:
Univ Hosp Schleswig Holstein, Dept Hematol & Oncol, Campus Kiel, Kiel, Germany
Martinez-de-Sola, M:
Hosp Parc Tauli, Clin Hematol Dept, Sabadell, Spain
Stauder, R:
Innsbruck Med Univ, Dept Internal Med Hematol & Oncol 5, Innsbruck, Austria
Merchan, B:
Univ Hosp Vall dHebron, Dept Hematol, Barcelona, Spain
List, A:
H Lee Moffitt Canc Ctr & Res Inst, Dept Malignant Hematol, Tampa, FL USA
Ganster, C:
Univ Med Ctr Gottingen, Dept Hematol & Med Oncol, Gottingen, Germany
Schroeder, T:
Univ Hosp Duesseldorf, Dept Hematol Oncol & Clin Immunol, Dusseldorf, Germany
Voso, MT:
Tor Vergata Univ, Dept Biomed & Prevent, Rome, Italy
Pfeilstocker, M:
Hanusch Krankenhaus Wien, Vienna, Austria
Sill, H:
Med Univ Graz, Graz, Austria
Hildebrandt, B:
Univ Duesseldorf, Inst Human Genet, Dusseldorf, Germany
Esteve, J:
Hosp Clin Barcelona, Clin Hematol Dept, IDIBAPS, Barcelona, Spain
Nomdedeu, B:
Hosp Clin Barcelona, Clin Hematol Dept, IDIBAPS, Barcelona, Spain
Cobo, F:
Hosp Quiron Teknon, Clin Hematol Dept, Barcelona, Spain
Haas, R:
Univ Hosp Duesseldorf, Dept Hematol Oncol & Clin Immunol, Dusseldorf, Germany
Francesc Solé:
Josep Carreras Leukemia Res Inst, MDS Grp, Barcelona, Spain
Germing, U:
Univ Hosp Duesseldorf, Dept Hematol Oncol & Clin Immunol, Dusseldorf, Germany
Greenberg, PL:
Stanford Univ, Ctr Canc, Stanford, CA 94305 USA
Haase, D:
Univ Med Ctr Gottingen, Dept Hematol & Med Oncol, Gottingen, Germany
Sanz, G:
Hosp Univ I Politecn la Fe, Clin Hematol Dept, Valencia, Spain
Green Published, hybrid
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