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Is there a pressing need for improving prognostication strategies in therapy-related myelodysplastic syndromes?

Leukemia volume 31, pages 2538–2539 (2017)Cite this article

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We read with interest the paper from Zeidan et al.,1 who assess the prognostic utility of classical risk stratification tools in patients with therapy-related myelodysplastic syndromes (t-MDS).

The 2008 WHO category of therapy-related myeloid neoplasms (t-MN) includes therapy-related acute myeloid leukemias (t-AML), t-MDS and myelodysplastic/myeloproliferative neoplasms (t-MDS/MPN) occurring as late complications of chemotherapy and/or radiotherapy administered for a prior neoplastic or non-neoplastic disorder.2 Few reports have suggested that neither the WHO subclassification of MDS nor the blast percentage permitted to stratify patients based on their clinical outcomes. Likewise, no differences in outcome were observed between t-MDS and t-AML.3 Based on these data, t-MDS, t-MDS/MPN and t-AML were considered together as a unique clinical syndrome. By contrast, recent data reveal that patients with t-MDS may be stratified in different prognostic subgroups, some of them presenting an indolent course.1, 4 Moreover, sporadic cases diagnosed with t-MDS would really be de novo MDS. In this line, Nardi et al. showed that MDS occurring after external-beam radiation presented no differences in outcome or in the presence of high-risk karyotypes when compared with de novo MDS, suggesting that post-radiation MDS might not represent a direct consequence of this exposure.5

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References

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  1. Laboratorio de Citología Hematológica, Servicio de Patología, GRETNHE, IMIM Hospital del Mar Research Institute, Barcelona, Spain

    X Calvo, L Florensa & L Arenillas

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  1. X Calvo
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Correspondence to X Calvo.

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Calvo, X., Florensa, L. & Arenillas, L. Is there a pressing need for improving prognostication strategies in therapy-related myelodysplastic syndromes?. Leukemia 31, 2538–2539 (2017). https://doi.org/10.1038/leu.2017.237

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