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).
Stahl M., Bewersdorf JP., Xie Z., Porta MGD., Komrokji R., Xu ML., Abdel-Wahab O., Taylor J., Steensma DP., Starczynowski DT., Sekeres MA., Sanz G., Sallman DA., Roboz GJ., Platzbecker U., Patnaik MM., Padron E., Odenike O., Nimer SD., Nazha A., Majeti R., Loghavi S., Little RF., List AF., Kim TK., Hourigan CS., Hasserjian RP., Halene S., Griffiths EA., Gore SD., Greenberg P., Figueroa ME., Fenaux P., Efficace F., DeZern AE., Daver NG., Churpek JE., Carraway HE., Buckstein R., Brunner AM., Boultwood J., Borate U., Bejar R., Bennett JM., Wei AH., Santini V., Savona MR., Zeidan AM.
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.