Therapy-related myelodysplastic syndromes deserve specific diagnostic sub-classification and risk-stratification-an approach to classification of patients with t-MDS.
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Kuendgen A
Department of Hematology, Oncology, and Clinical Immunology, University Hospital Duesseldorf, Duesseldorf, Germany. kuendgen@med.uni-duesseldorf.de.
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Nomdedeu M
Department of Laboratory Hematology, Institut Català d'Oncologia Hospital GermansTrias I Pujol, Badalona, Spain.
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Tuechler H
Boltzmann Institute for Leukemia Research, Hanusch Hospital, Vienna, Austria.
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Garcia-Manero G
Department of Leukemia, MD Anderson Cancer Center, Houston, TX, USA.
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Komrokji RS
Department of Malignant Hematology, H Lee Moffitt Cancer Center, Tampa, FL, USA.
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Sekeres MA
Leukemia Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
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Della Porta MG
Cancer Center - IRCCS Humanitas Research Hospital & Humanitas University, Rozzano - Milan, Italy.
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Cazzola M
Department of Hematology Oncology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
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DeZern AE
Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA.
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Roboz GJ
Weill Cornell Medicine and The New York Presbyterian Hospital, New York, NY, USA.
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Steensma DP
Dana-Farber Cancer Institute, Boston, MA, USA.
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Van de Loosdrecht AA
Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
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Schlenk RF
Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.
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Grau J
Department of Laboratory Hematology, Institut Català d'Oncologia Hospital GermansTrias I Pujol, Badalona, Spain.
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Calvo X
Hematological Citology Laboratory, Pathology Department, Hospital del Mar, GRETNHE, IMIM Hospital del Mar Research Institute, Barcelona, Spain.
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Blum S
Service of Hematology, University Hospital Lausanne, Lausanne, Switzerland.
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Pereira A
Hemotherapy and Hemostasis Department, Hospital Clínic de Barcelona IDIBAPS, Barcelona, Spain.
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Valent P
Department of Internal Medicine I, Division of Hematology & Hemostaseology and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.
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Costa D
Hematopathology Section, Hospital Clínic de Barcelona IDIBAPS, Barcelona, Spain.
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Giagounidis A
Department of Oncology, Hematology and Palliative Care, Marienhospital Duesseldorf, Duesseldorf, Germany.
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Xicoy B
Clinical Hematology Department, Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Bellaterra, Spain.
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Döhner H
Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.
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Platzbecker U
University Hospital Leipzig, Leipzig, Germany.
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Pedro C
Clinical Hematology Department, Hospital del Mar, Barcelona, Spain.
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Lübbert M
Department of Hematology, Oncology and Stem Cell Transplantation, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.
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Oiartzabal I
Clinical Hematology Department, Hospital Universitario Araba, Vitoria-Gasteiz, Spain.
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Díez-Campelo M
Clinical Hematology Department, Hospital Universitario de Salamanca (HUSA), Salamanca, Spain.
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Cedena MT
Clinical Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
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Machherndl-Spandl S
1st. Internal Department - Hematology with stem cell transplants, Hemostaseology and Medical Oncology, Elisabethinen Hospital, Linz, Austria.
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López-Pavía M
Clinical Hematology Department, Hospital General Universitari de València, Valencia, Spain.
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Baldus CD
Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
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Martinez-de-Sola M
Clinical Hematology Department, Hospital Parc Taulí, Sabadell, Spain.
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Stauder R
Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria.
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Merchan B
Department of Hematology, University Hospital Vall d´Hebrón, Barcelona, Spain.
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List A
Department of Malignant Hematology, H Lee Moffitt Cancer Center, Tampa, FL, USA.
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Ganster C
Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany.
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Schroeder T
Department of Hematology, Oncology, and Clinical Immunology, University Hospital Duesseldorf, Duesseldorf, Germany.
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Voso MT
Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.
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Pfeilstöcker M
Hanusch Krankenhaus Wien, Vienna, Austria.
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Sill H
Medizinische Universität Graz, Graz, Austria.
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Hildebrandt B
Institute of Human Genetics, University Duesseldorf, Duesseldorf, Germany.
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Esteve J
Clinical Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
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Nomdedeu B
Clinical Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.
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Cobo F
Clinical Hematology Department, Hospital Quirón Teknon, Barcelona, Spain.
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Haas R
Department of Hematology, Oncology, and Clinical Immunology, University Hospital Duesseldorf, Duesseldorf, Germany.
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Sole F
MDS Group, Josep Carreras Leukemia Research Institute, Barcelona, Spain.
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Germing U
Department of Hematology, Oncology, and Clinical Immunology, University Hospital Duesseldorf, Duesseldorf, Germany.
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Greenberg PL
Stanford University Cancer Center, Stanford, CA, USA.
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Haase D
Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany.
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Sanz G
Clinical Hematology Department, Hospital Universitari I Politècnic la Fe, Valencia, Spain.
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English
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 (both p < 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.
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hybrid
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https://sonar.ch/global/documents/740
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