In 2022, two novel classification systems for myelodysplastic syndromes/neoplasms (MDS) have been proposed: the International Consensus Classification (ICC) and the 2022 World Health Organization (WHO-2022) classification. These two contemporary systems exhibit numerous shared features but also diverge significantly in terminology and the definition of new entities. Thus, we retrospectively validated the ICC and WHO-2022 classification and found that both systems promoted efficient segregation of this heterogeneous disease. After examining the distinction between the two systems, we showed that a peripheral blood blast percentage ≥ 5% indicates adverse survival. Identifying MDS/acute myeloid leukemia with MDS-related gene mutations or cytogenetic abnormalities helps differentiate survival outcomes. In MDS, not otherwise specified patients, those diagnosed with hypoplastic MDS and single lineage dysplasia displayed a trend of superior survival compared to other low-risk MDS patients. Furthermore, the impact of bone marrow fibrosis on survival was less pronounced within the ICC framework. Allogeneic transplantation appears to improve outcomes for patients diagnosed with MDS with excess blasts in the ICC. Therefore, we proposed an integrated system that may lead to the accurate diagnosis and advancement of future research for MDS. Prospective studies are warranted to validate this refined classification.
2022年，针对骨髓增生异常综合征/肿瘤（MDS）提出了两种新的分类体系：国际共识分类（ICC）和2022年世界卫生组织分类（WHO-2022）。这两种当代体系在具有诸多共同特征的同时，也在术语及新实体的定义上存在显著差异。因此，我们回顾性地验证了ICC与WHO-2022分类体系，发现两者均能有效区分这一异质性疾病。在分析两种体系的区别后，我们证实外周血原始细胞比例≥5%提示不良预后。识别具有MDS相关基因突变或细胞遗传学异常的MDS/急性髓系白血病有助于区分生存结局。在非特指型MDS患者中，诊断为低增生性MDS和单系发育异常的患者相较于其他低危MDS患者显示出更优的生存趋势。此外，骨髓纤维化对生存的影响在ICC框架内较为有限。异基因移植似乎能改善ICC分类中原始细胞增多型MDS患者的预后。基于此，我们提出了一个整合性分类体系，可能促进MDS的精准诊断和未来研究进展。尚需开展前瞻性研究以验证这一精细化分类体系。
肿瘤(癌症)患者之家