Classification, risk stratification and response assessment in myelodysplastic syndromes/neoplasms (MDS): A state-of-the-art report on behalf of the International Consortium for MDS (icMDS)

Maximilian Stahl; Jan Philipp Bewersdorf; Zhuoer Xie; Matteo Giovanni Della Porta; Rami Komrokji; Mina L Xu; Omar Abdel-Wahab; Justin Taylor; David P Steensma; Daniel T Starczynowski; Mikkael A Sekeres; Guillermo Sanz; David A Sallman; Gail J Roboz; Uwe Platzbecker; Mrinal M Patnaik; Eric Padron; Olatoyosi Odenike; Stephen D Nimer; Aziz Nazha; Ravi Majeti; Sanam Loghavi; Richard F Little; Alan F List; Tae Kon Kim; Christopher S Hourigan; Robert P Hasserjian; Stephanie Halene; Elizabeth A Griffiths; Steven D Gore; Peter Greenberg; Maria E Figueroa; Pierre Fenaux; Fabio Efficace; Amy E DeZern; Naval G Daver; Jane E Churpek; Hetty E Carraway; Rena Buckstein; Andrew M Brunner; Jacqueline Boultwood; Uma Borate; Rafael Bejar; John M Bennett; Andrew H Wei; Valeria Santini; Michael R Savona; Amer M Zeidan

doi:10.1016/j.blre.2023.101128

Classification, risk stratification and response assessment in myelodysplastic syndromes/neoplasms (MDS): A state-of-the-art report on behalf of the International Consortium for MDS (icMDS)

Blood Rev. 2023 Nov:62:101128. doi: 10.1016/j.blre.2023.101128. Epub 2023 Aug 19.

Authors

Maximilian Stahl¹, Jan Philipp Bewersdorf², Zhuoer Xie³, Matteo Giovanni Della Porta⁴, Rami Komrokji³, Mina L Xu⁵, Omar Abdel-Wahab², Justin Taylor⁶, David P Steensma⁷, Daniel T Starczynowski⁸, Mikkael A Sekeres⁶, Guillermo Sanz⁹, David A Sallman³, Gail J Roboz¹⁰, Uwe Platzbecker¹¹, Mrinal M Patnaik¹², Eric Padron³, Olatoyosi Odenike¹³, Stephen D Nimer⁶, Aziz Nazha¹⁴, Ravi Majeti¹⁵, Sanam Loghavi¹⁶, Richard F Little¹⁷, Alan F List¹⁸, Tae Kon Kim¹⁹, Christopher S Hourigan²⁰, Robert P Hasserjian²¹, Stephanie Halene²², Elizabeth A Griffiths²³, Steven D Gore¹⁷, Peter Greenberg²⁴, Maria E Figueroa⁶, Pierre Fenaux²⁵, Fabio Efficace²⁶, Amy E DeZern²⁷, Naval G Daver²⁸, Jane E Churpek²⁹, Hetty E Carraway³⁰, Rena Buckstein³¹, Andrew M Brunner³², Jacqueline Boultwood³³, Uma Borate³⁴, Rafael Bejar³⁵, John M Bennett³⁶, Andrew H Wei³⁷, Valeria Santini³⁸, Michael R Savona¹⁹, Amer M Zeidan³⁹

Affiliations

¹ Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
² Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
³ Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
⁴ IRCCS Humanitas Clinical and Research Center & Humanitas University, Department of Biomedical Sciences, via Manzoni 56, 20089, Rozzano, Milan, Italy.
⁵ Departments of Pathology & Laboratory Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA.
⁶ Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
⁷ David Steensma LLC, Cambridge, Massachusetts 02139, USA.
⁸ Division of Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
⁹ Health Research Institute La Fe, Valencia, Spain; Hospital Universitario y Politécnico La Fe, Valencia, Spain; CIBERONC, IS Carlos III, Madrid, Spain.
¹⁰ Weill Cornell Medical College and New York Presbyterian Hospital, New York, NY, USA.
¹¹ Leipzig University Hospital, Leipzig, Germany.
¹² Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
¹³ Leukemia Program, University of Chicago Medicine and University of Chicago Comprehensive Cancer Center, Chicago, IL, USA.
¹⁴ Department of Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
¹⁵ Division of Hematology, Department of Medicine, Cancer Institute, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
¹⁶ Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
¹⁷ National Cancer Institute, Cancer Therapy Evaluation Program, Rockville, MD, USA.
¹⁸ Precision BioSciences, Inc., Durham, NC, USA.
¹⁹ Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
²⁰ Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, and Myeloid Malignancies Program, National Institutes of Health, Bethesda, MD, 20892, USA.
²¹ Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.
²² Section of Hematology, Department of Internal Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA.
²³ Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
²⁴ Division of Hematology, Department of Medicine, Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA.
²⁵ Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris and Paris Cité University, Paris, France.
²⁶ Italian Group for Adult Hematologic Diseases (GIMEMA), Health Outcomes Research Unit, Rome, Italy.
²⁷ Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD, USA.
²⁸ Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
²⁹ Department of Hematology, Oncology, and Palliative Care, Carbone Cancer Center, The University of Wisconsin-Madison, Madison, WI, USA.
³⁰ Leukemia Program, Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
³¹ Department of Medical Oncology/ Hematology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
³² Leukemia Program, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
³³ Blood Cancer UK Molecular Haematology Unit, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
³⁴ Ohio State University Comprehensive Cancer Center/ James Cancer Hospital, Ohio State University, Columbus, OH, USA.
³⁵ Division of Hematology and Oncology, Moores Cancer Center, UC San Diego, La Jolla, CA, USA.
³⁶ University of Rochester Medical Center, Department of Pathology and Laboratory Medical Center, Rochester, NY, USA.
³⁷ Department of Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital, Walter and Eliza Hall Institute of Medical Research and University of Melbourne, Victoria, Australia.
³⁸ MDS Unit, Hematology, AOUC, University of Florence, Italy.
³⁹ Section of Hematology, Department of Internal Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA. Electronic address: amer.zeidan@yale.edu.

PMID: 37704469
DOI: 10.1016/j.blre.2023.101128

Abstract

The guidelines for classification, prognostication, and response assessment of myelodysplastic syndromes/neoplasms (MDS) have all recently been updated. In this report on behalf of the International Consortium for MDS (icMDS) we summarize these developments. We first critically examine the updated World Health Organization (WHO) classification and the International Consensus Classification (ICC) of MDS. We then compare traditional and molecularly based risk MDS risk assessment tools. Lastly, we discuss limitations of criteria in measuring therapeutic benefit and highlight how the International Working Group (IWG) 2018 and 2023 response criteria addressed these deficiencies and are endorsed by the icMDS. We also address the importance of patient centered care by discussing the value of quality-of-life assessment. We hope that the reader of this review will have a better understanding of how to classify MDS, predict clinical outcomes and evaluate therapeutic outcomes.

Keywords: Diagnostic criteria; IPSS-M; MDS; Myelodysplastic syndrome; Novel therapies; Risk classification.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Myelodysplastic Syndromes* / diagnosis
Myelodysplastic Syndromes* / therapy
Neoplasms*
Prognosis
Quality of Life
Risk Assessment