Therapy-related myelodysplastic syndromes deserve specific diagnostic sub-classification and risk-stratification-an approach to classification of patients with t-MDS

被引：59

作者：

Kuendgen, A. ^{[1
]}

Nomdedeu, M. ^{[2
]}

Tuechler, H. ^{[3
]}

Garcia-Manero, G. ^{[4
]}

Komrokji, R. S. ^{[5
]}

Sekeres, M. A. ^{[6
]}

Della Porta, M. G. ^{[7
,8
]}

Cazzola, M. ^{[9
]}

DeZern, A. E. ^{[10
]}

Roboz, G. J. ^{[11
,12
]}

Steensma, D. P. ^{[13
]}

Van de Loosdrecht, A. A. ^{[14
]}

Schlenk, R. F. ^{[15
,16
,17
]}

Grau, J. ^{[2
]}

Calvo, X. ^{[18
]}

Blum, S. ^{[19
]}

Pereira, A. ^{[20
]}

Valent, P. ^{[21
,22
]}

Costa, D. ^{[23
]}

Giagounidis, A. ^{[24
]}

Xicoy, B. ^{[25
,26
]}

Doehner, H. ^{[15
]}

Platzbecker, U. ^{[27
]}

Pedro, C. ^{[28
]}

Luebbert, M. ^{[29
]}

Oiartzabal, I ^{[30
]}

Diez-Campelo, M. ^{[31
]}

Cedena, M. T. ^{[32
]}

Machherndl-Spandl, S. ^{[33
]}

Lopez-Pavia, M. ^{[34
]}

Baldus, C. D. ^{[35
]}

Martinez-de-Sola, M. ^{[36
]}

Stauder, R. ^{[37
]}

Merchan, B. ^{[38
]}

List, A. ^{[5
]}

Ganster, C. ^{[39
]}

Schroeder, T. ^{[1
]}

Voso, M. T. ^{[40
]}

Pfeilstoecker, M. ^{[41
]}

Sill, H. ^{[42
]}

Hildebrandt, B. ^{[43
]}

Esteve, J. ^{[44
]}

Nomdedeu, B. ^{[44
]}

Cobo, F. ^{[45
]}

Haas, R. ^{[1
]}

Sole, F. ^{[46
]}

Germing, U. ^{[1
]}

Greenberg, P. L. ^{[47
]}

Haase, D. ^{[39
]}

Sanz, G. ^{[48
]}

机构：

[1] Univ Hosp Duesseldorf, Dept Hematol Oncol & Clin Immunol, Dusseldorf, Germany

[2] Inst Catala Oncol Hosp GermansTrias I Pujol, Dept Lab Hematol, Badalona, Spain

[3] Hanusch Hosp, Boltzmann Inst Leukemia Res, Vienna, Austria

[4] MD Anderson Canc Ctr, Dept Leukemia, Houston, TX USA

[5] H Lee Moffitt Canc Ctr & Res Inst, Dept Malignant Hematol, Tampa, FL USA

[6] Cleveland Clin, Dept Hematol & Med Oncol, Taussig Canc Inst, Leukemia Program, Cleveland, OH 44106 USA

[7] IRCCS Humanitas Res Hosp, Canc Ctr, Rozzano Milan, Italy

[8] Humanitas Univ, Rozzano Milan, Italy

[9] IRCCS Policlin San Matteo Fdn, Dept Hematol Oncol, Pavia, Italy

[10] Johns Hopkins Univ, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD USA

[11] Weill Cornell Med, New York, NY USA

[12] New York Presbyterian Hosp, New York, NY USA

[13] Dana Farber Canc Inst, Boston, MA 02115 USA

[14] Vrije Univ Amsterdam, Amsterdam UMC, Amsterdam, Netherlands

[15] Univ Hosp Ulm, Dept Internal Med 3, Ulm, Germany

[16] German Canc Res Ctr, Natl Ctr Tumor Dis, Trial Ctr, Heidelberg, Germany

[17] Heidelberg Univ Hosp, Dept Internal Med 5, Heidelberg, Germany

[18] IMIM Hosp del Mar Res Inst, Hematol Citol Lab, Pathol Dept, Hosp del Mar,GRETNHE, Barcelona, Spain

[19] Univ Hosp Lausanne, Serv Hematol, Lausanne, Switzerland

[20] Hosp Clin Barcelona IDIBAPS, Hemotherapy & Hemostasis Dept, Barcelona, Spain

[21] Med Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol, Vienna, Austria

[22] Med Univ Vienna, Ludwig Boltzmann Inst Hematol & Oncol, Vienna, Austria

[23] Hosp Clin Barcelona IDIBAPS, Hematopathol Sect, Barcelona, Spain

[24] Marienhosp Duesseldorf, Dept Oncol Hematol & Palliat Care, Dusseldorf, Germany

[25] Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol, Clin Hematol Dept, Badalona, Spain

[26] Univ Autonoma Barcelona, Josep Carreras Leukemia Res Inst, Bellaterra, Spain

[27] Univ Hosp Leipzig, Leipzig, Germany

[28] Hosp del Mar, Clin Hematol Dept, Barcelona, Spain

[29] Univ Med Ctr Freiburg, Fac Med, Dept Hematol Oncol & Stem Cell Transplantat, Freiburg, Germany

[30] Hosp Univ Araba, Clin Hematol Dept, Vitoria, Spain

[31] Hosp Univ Salamanca HUSA, Clin Hematol Dept, Salamanca, Spain

[32] Hosp Univ 12 Octubre, Clin Hematol Dept, Madrid, Spain

[33] Elisabethinen Hosp, Internal Dept Hematol Stem Cell Transplants Hemos, Linz, Austria

[34] Hosp Gen Univ Valencia, Clin Hematol Dept, Valencia, Spain

[35] Univ Hosp Schleswig Holstein, Dept Hematol & Oncol, Campus Kiel, Kiel, Germany

[36] Hosp Parc Tauli, Clin Hematol Dept, Sabadell, Spain

[37] Innsbruck Med Univ, Dept Internal Med Hematol & Oncol 5, Innsbruck, Austria

[38] Univ Hosp Vall dHebron, Dept Hematol, Barcelona, Spain

[39] Univ Med Ctr Gottingen, Dept Hematol & Med Oncol, Gottingen, Germany

[40] Tor Vergata Univ, Dept Biomed & Prevent, Rome, Italy

[41] Hanusch Krankenhaus Wien, Vienna, Austria

[42] Med Univ Graz, Graz, Austria

[43] Univ Duesseldorf, Inst Human Genet, Dusseldorf, Germany

[44] Hosp Clin Barcelona, Clin Hematol Dept, IDIBAPS, Barcelona, Spain

[45] Hosp Quiron Teknon, Clin Hematol Dept, Barcelona, Spain

[46] Josep Carreras Leukemia Res Inst, MDS Grp, Barcelona, Spain

[47] Stanford Univ, Ctr Canc, Stanford, CA 94305 USA

[48] Hosp Univ I Politecn la Fe, Clin Hematol Dept, Valencia, Spain

来源：

LEUKEMIA | 2021年 / 35卷 / 03期

基金：

奥地利科学基金会;

关键词：

ACUTE MYELOID-LEUKEMIA; PROGNOSTIC SCORING SYSTEM; WORLD-HEALTH-ORGANIZATION; CLONAL HEMATOPOIESIS; PREDICTING SURVIVAL; NEOPLASMS; MODEL; ABNORMALITIES; REVISION; FEATURES;

D O I：

10.1038/s41375-020-0917-7

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：835 / 849

页数：15

共 3 条

[1] Therapy-related myelodysplastic syndromes-specific risk stratification: are we putting the cart before the horse?
Zeidan, A. M.
Sekeres, M. A.
Barnard, J.
Steensma, D. P.
Komrokji, R.
LEUKEMIA, 2017, 31 (11) : 2539 - 2541
[2] A review of therapy-related myelodysplastic syndromes and acute myeloid leukaemia (t-MDS/AML) in Irish patients: a single centre experience
Maung, Su W.
Burke, Cathie
Hayde, Jennifer
Walshe, Janice
McDermott, Ray
Desmond, Ronan
McHugh, Johnny
Enright, Helen
HEMATOLOGY, 2017, 22 (06) : 341 - 346
[3] Comparison of clinical outcomes and prognostic utility of risk stratification tools in patients with therapy-related vs de novo myelodysplastic syndromes: a report on behalf of the MDS Clinical Research Consortium
Zeidan, A. M.
Al Ali, N.
Barnard, J.
Padron, E.
Lancet, J. E.
Sekeres, M. A.
Steensma, D. P.
DeZern, A.
Roboz, G.
Jabbour, E.
Garcia-Manero, G.
List, A.
Komrokji, R.
LEUKEMIA, 2017, 31 (06) : 1391 - 1397

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