A team of researchers performed a study to evaluate and compare two recently released international classification systems for myelodysplastic syndromes (MDS). The team was affiliated with National Taiwan University Hospital, and they presented their findings at the European Hematology Association 2024 Hybrid Congress in Madrid, Spain.
The team compared the fifth edition of the World Health Organization (WHO) MDS classification system and the International Consensus Classification (ICC) system. Both systems were released in 2022.
To make this comparison, the researchers retrospectively reviewed 635 patients diagnosed with primary MDS using the fourth edition of the WHO classification system and then reclassified them according to the two new systems. The median age of the patient cohort was 69 years, and there was a male-to-female ratio of 1.7.
In this study, the researchers sought to create a single integrated system from the two MDS classification systems that could help guide treatment decisions. Toward this goal, they created a modified version of the ICC system. They based their changes on the differences in median overall survival (OS) they found between MDS categories in the review.
The specific changes the researchers made to the base ICC system were to differentiate hypoplastic MDS from low-risk MDS and reduce the peripheral blood blast threshold to less than 5% for MDS with excess blasts.
Multivariable analysis showed the refined system (P<.001), older patient age (P<.001), and the Molecular International Prognostic Scoring System (P<.001) independently predict leukemic-free survival and OS.
The team concluded that both MDS systems effectively account for the heterogeneity seen in this disease but have difficulties in clinical use for diagnosis and management.
“[W]e propose an integrated classification system that amalgamates the strengths of both systems to enhance precision in MDS classifications and facilitate the development of risk-adapted treatment strategies,” the researchers wrote.
Reference
Chang YS, Lee WH, Lin CC, et al. Comparison of the 2022 World Health Organization classification and International Consensus Classification in myelodysplastic syndromes (MDS). Abstract P1908. Presented at the European Hematology Association 2024 Hybrid Congress; June 13-16, 2024; Madrid, Spain.