MDS subclassification—do we still have to count blasts?

Huber, Sandra; Haferlach, Torsten; Müller, Heiko; Meggendorfer, Manja; Hütter, Stephan; Hoermann, Gregor; Baer, Constance; Kern, Wolfgang; Haferlach, Claudia

doi:10.1038/s41375-023-01855-7

Cited by 17 publications

(4 citation statements)

References 14 publications

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“…21 Instead, several studies have already addressed the validation of ELN 2022, 9,12 confirming its discriminatory capability, which is similar to that provided by the ELN 2017 stratification, 14 since the correlation between both classifications is higher than 80%. 22 These studies analysed a broad validation of the new classification in the overall population, accounting for initial refractoriness and relapse at diagnosis had presented at least a molecular failure before being chosen to undergo an allo-HCT. Otherwise, a treatment based exclusively on standard chemotherapy would have been the preferred treatment option based on our protocol, as previously explained.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of European LeukemiaNet 2022 risk classification in patients undergoing allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia: Identification of a very poor prognosis genetic group

Jiménez‐Vicente,

Charry,

Castaño‐Diez

et al. 2024

Br J Haematol

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SummaryEuropean LeukemiaNet refined their risk classification of acute myeloid leukaemia (AML) in 2022 (ELN 2022) according to the two new myeloid classifications published the same year. We have retrospectively assessed the prognostic value of the ELN 2022 in 120 AML patients undergoing allogeneic haematopoietic cell transplantation (allo‐HCT), including 99 in first complete response (CR1) from 2011 to 2021 in our centre. Adverse risk patients (Adv) presented inferior outcome in terms of overall survival (OS) and leukaemia‐free survival (LFS) (OS [p = 0.003], LFS [p = 0.02]), confirmed in multivariate analysis (hazard ratio [HR] for OS = 2.00, p = 0.037). These results were also seen in patients allografted in CR1. Further analysis identified a subgroup named adverse‐plus (AdvP), including complex karyotype, MECOM(EVI1) rearrangements and TP53 mutations, with worse outcomes than the rest of groups of patients, including the Adv (HR for OS: 3.14, p < 0.001, HR for LFS: 3.36, p < 0.001), with higher 2‐year cumulative incidence of relapse (p < 0.001). Notably, within this analysis, the outcome of Adv and intermediate patients were similar. These findings highlight the prognostic value of ELN 2022 in patients undergoing allo‐HCT, which can be improved by the recognition of a poor genetic subset (AdvP) within the Adv risk group.

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Section: Discussionmentioning

confidence: 99%

Evaluation of European LeukemiaNet 2022 risk classification in patients undergoing allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia: Identification of a very poor prognosis genetic group

Jiménez‐Vicente,

Charry,

Castaño‐Diez

et al. 2024

Br J Haematol

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“…One could argue that blast cell thresholds remain inevitable in the field of MDS and AML. In contrast, we previously showed that a genetic-based MDS subclassification better reflects biology than blast counts and that the latter is rather a sequela of the former than an independent biological category [ 12 ]. This concept has the potential to improve outcome prediction and individual treatment choice beyond blast cell counting.…”

Section: To the Editormentioning

confidence: 99%

Risk assessment according to IPSS-M is superior to AML ELN risk classification in MDS/AML overlap patients defined by ICC

Huber,

Baer,

Hutter

et al. 2023

Leukemia

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“…This requires the integration of clinical data, bone marrow morphology, immunophenotyping, cytogenetics, and molecular analysis, which can be a formidable challenge for general hematologists. 5,6 A trend to deal with complex challenges in healthcare has been the development of digital tools for medical education and to support medical decisions. 7,8 An example is the eGVHD app, 9,10 Within this app, users input clinical and laboratory data, including personal and family history, bone marrow morphology findings, cytogenetic information, immunophenotyping results, and molecular data.…”

Section: Introductionmentioning

confidence: 99%

“…Today, a comprehensive diagnosis of AML involves the World Health Organization (WHO) classification, risk stratification, identification of biomarkers with therapeutic and disease monitoring potential, and the recognition of cases linked to germline predisposition syndromes. This requires the integration of clinical data, bone marrow morphology, immunophenotyping, cytogenetics, and molecular analysis, which can be a formidable challenge for general hematologists 5,6 …”

Section: Introductionmentioning

confidence: 99%

Feasibility, accuracy, and usability analysis of MapAML, a first‐in‐class app for integrated diagnosis in acute myeloid leukemia

Moyen,

Tomaz,

Campregher

2024

European J of Haematology

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Performing a comprehensive diagnosis of acute myeloid leukemia (AML) is complex and involves the integration of clinical information, bone marrow morphology, immunophenotyping, cytogenetic, and molecular analysis, which can be challenging to the general hematologist. The aim of this study was to evaluate the usability and accuracy of MapAML, a smartphone app for integrated diagnosis in AML, created to aid the hematologist in its clinical practice. App performance was evaluated in dedicated sessions, in which 21 hematologists or fellows in hematology performed an integrated diagnosis of deidentified real‐world clinical AML cases, first without and posteriorly with MapAML use. Diagnosis accuracy increased after MapAML utilization, with the average score going from 7.08 without app to 8.88 with app use (on a scale from 0 to 10), representing a significant accuracy improvement (p = .002). Usability evaluation was very favorable, with 81% of users considering the app very or extremely simple to use. There was also a significant increase in confidence to perform a complete and accurate diagnosis in AML after app use, with 61.9% of the participants willing to use the app in their clinical practice. In this study, MapAML increased accuracy with excellent usability for integrated diagnosis in AML.

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MDS subclassification—do we still have to count blasts?

Cited by 17 publications

References 14 publications

Evaluation of European LeukemiaNet 2022 risk classification in patients undergoing allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia: Identification of a very poor prognosis genetic group

Evaluation of European LeukemiaNet 2022 risk classification in patients undergoing allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia: Identification of a very poor prognosis genetic group

Risk assessment according to IPSS-M is superior to AML ELN risk classification in MDS/AML overlap patients defined by ICC

Feasibility, accuracy, and usability analysis of MapAML, a first‐in‐class app for integrated diagnosis in acute myeloid leukemia

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