(HealthDay News) — Clinical characteristics, outcomes, and genetic features vary across subtypes of myelodysplastic syndrome (MDS) categorized using the 2022 International Consensus Classification (ICC), according to a study published in the American Journal of Hematology.

Researchers examined how the 2022 ICC would reclassify patients with MDS diagnosed according to the 2016 World Health Organization (WHO) classification.

According to the ICC, MDS with blasts of 10% to 19% was classified as MDS/acute myeloid leukemia (AML). MDS with mutated SF3B1, irrespective of the number of ring sideroblasts, was classified as MDS-SF3B1. And MDS with multi-hit TP53 mutations was classified as MDS with mutated TP53.

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A total of 716 patients with MDS diagnosed according to the 2016 WHO classification were recategorized. The researchers found that, based on the ICC, 75.3% of patients remained in the MDS group. After excluding 15 patients who were classified to the AML group, 24.7% were reclassified to the MDS/AML group.

A distinct mutational landscape and worse outcomes were seen for patients with MDS/AML vs those with MDS. Patients with MDS-SF3B1 had higher frequencies of DNMT3A and TET2 mutations than those with MDS not otherwise specified, with single lineage or multilineage dysplasia. Poor outcomes were seen for patients with mutated TP53, regardless of the blast percentage.

“The ICC ensures efficient segregation of this heterogeneous disease, with emphasis on the differences in molecular landscapes and prognoses among different disease subsets, which can help in accurate MDS diagnosis and effective risk-adapted treatment of patients with MDS,” the study authors wrote.

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