When to use which molecular prognostic scoring system in the management of patients with MDS?

IF 2.2 4区 医学 Q3 HEMATOLOGY
Tariq Kewan , Jan Philipp Bewersdorf , Carmelo Gurnari , Zhuoer Xie , Maximilian Stahl , Amer M. Zeidan
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引用次数: 0

Abstract

Myelodysplastic syndromes/neoplasms (MDS) are a heterogeneous group of hematopoietic cancers characterized by recurrent molecular alterations driving the disease pathogenesis with a variable propensity for progression to acute myeloid leukemia (AML). Clinical decision making for MDS relies on appropriate risk stratification at diagnosis, with higher-risk patients requiring more intensive therapy. The conventional clinical prognostic systems including the International Prognostic Scoring System (IPSS) and its revised version (IPSS-R) have dominated the risk stratification of MDS from 1997 until 2022. Concurrently, the use of next-generation sequencing has revolutionized the field by revealing multiple recurrent genetic mutations, which correlate with phenotype and prognosis. Significant efforts have been made to formally incorporate molecular data into prognostic tools to improve proper risk identification and personalize treatment strategies. In this review, we will critically compare the available molecular scoring systems for MDS focusing on areas of progress and potential limitations that can be improved in subsequent revisions of these tools.

在MDS患者的管理中,何时使用哪种分子预后评分系统?
骨髓增生异常综合征/肿瘤(MDS)是一组异质性造血癌症,其特征是复发性分子改变驱动疾病发病机制,具有发展为急性髓系白血病(AML)的可变倾向。MDS的临床决策依赖于诊断时适当的风险分层,高风险患者需要更强化的治疗。从1997年到2022年,包括国际预后评分系统(IPSS)及其修订版本(IPSS- r)在内的传统临床预后系统主导了MDS的风险分层。同时,下一代测序的使用通过揭示与表型和预后相关的多种复发性基因突变,彻底改变了该领域。在将分子数据正式纳入预后工具以改进适当的风险识别和个性化治疗策略方面已经做出了重大努力。在这篇综述中,我们将批判性地比较现有的MDS分子评分系统,重点关注这些工具在后续修订中可以改进的进展和潜在局限性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
42
审稿时长
35 days
期刊介绍: Best Practice & Research Clinical Haematology publishes review articles integrating the results from the latest original research articles into practical, evidence-based review articles. These articles seek to address the key clinical issues of diagnosis, treatment and patient management. Each issue follows a problem-orientated approach which focuses on the key questions to be addressed, clearly defining what is known and not known, covering the spectrum of clinical and laboratory haematological practice and research. Although most reviews are invited, the Editor welcomes suggestions from potential authors.
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