Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 9;14(1):57.
doi: 10.1038/s41408-024-01031-9.

Comparison of the 2022 world health organization classification and international consensus classification in myelodysplastic syndromes/neoplasms

Wan-Hsuan Lee  1   2   3 , Chien-Chin Lin  1   4 , Cheng-Hong Tsai  1   5 , Feng-Ming Tien  1   3 , Min-Yen Lo  1   3   6 , Mei-Hsuan Tseng  7 , Yuan-Yeh Kuo  7 , Shan-Chi Yu  8 , Ming-Chih Liu  8 , Chang-Tsu Yuan  3   8   9 , Yi-Tsung Yang  1   2   3 , Ming-Kai Chuang  1   4 , Bor-Sheng Ko  10   11   12 , Jih-Luh Tang  1   13 , Hsun-I Sun  7 , Yi-Kuang Chuang  7 , Hwei-Fang Tien  1   14 , Hsin-An Hou  15   16 , Wen-Chien Chou  1   4
Affiliations

Comparison of the 2022 world health organization classification and international consensus classification in myelodysplastic syndromes/neoplasms

Wan-Hsuan Lee et al. Blood Cancer J. .

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Case allocation from 2016 World Health Organization classification.
Case allocation from 2016 World Health Organization classification to 2022 International Consensus Classification and 2022 World Health Organization classification of 635 patients with myelodysplastic syndromes/neoplasms.
Fig. 2
Fig. 2. Kaplan-Meier curves for leukemia-free survival and overall survival in patients with myelodysplastic neoplasms based on the 2022 World Health Organization classification.
a Leukemia-free survival for patients with myelodysplastic neoplasms. b Overall survival for patients with myelodysplastic neoplasms.
Fig. 3
Fig. 3. Kaplan-Meier curves for leukemia-free survival and overall survival in patients with myelodysplastic neoplasms, categorized by the blast percentage.
a Leukemia-free survival for patients with myelodysplastic neoplasms. b Overall survival for patients with myelodysplastic neoplasms.
See this image and copyright information in PMC

References

    1. Tefferi A, Vardiman JW. Myelodysplastic syndromes. N Engl J Med. 2009;361:1872–85. doi: 10.1056/NEJMra0902908. - DOI - PubMed
    1. Sekeres MA, Taylor J. Diagnosis and treatment of myelodysplastic syndromes: a review. Jama. 2022;328:872–80. doi: 10.1001/jama.2022.14578. - DOI - PubMed
    1. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Haematopietic and Lymphoid Tissues (ed 3rd). Lyon: IARC Press; (2001).
    1. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. In: Swerdlow SHCE, Harris NL, et al., editor: Lyon: IARC; (2008).
    1. Swerdlow SHCE, Harris NL, et al. eds. WHO Classification fo Tumours of Haematopoietic and Lymphoid Tissues.: Lyon: IARC; (2017).

Publication types