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MYELODYSPLASTIC NEOPLASM

Finding consistency in classifications of myeloid neoplasms: a perspective on behalf of the International Workshop for Myelodysplastic Syndromes

Leukemia volume 36, pages 2939–2946 (2022)Cite this article

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Myelodysplastic syndromes (MDS) include a heterogenous group of clonal hematopoietic neoplasms characterized by dysplastic morphologic changes in one or more hematopoietic lineages in the bone marrow and/or peripheral blood, various degrees of cytopenias and a risk of progression to acute myeloid leukemia (AML) [1]. The World Health Organization (WHO) classification of Hematolymphoid Tumors has been used widely for pathological reporting, clinical decision-making, clinical trial eligibility, drug labels, and disease registry reporting across the world. With advances in diagnostic techniques such as molecular testing, and the increased understanding of the close link between the genetic landscape of MDS, disease biology, and phenotype, a revised classification incorporating these disease aspects was published in 2022 as part of the 5th edition of the WHO classification of diseases [1,2,3,4].

Concurrently, an International Consensus Classification (ICC) of myeloid neoplasms and acute leukemia, which also incorporates clinical, histopathologic and molecular data for myeloid and lymphoid malignancies, including MDS, was published in 2022 [5].

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Acknowledgements

AMZ is a Leukemia and Lymphoma Society Scholar in Clinical Research. MEF is a Leukemia and Lymphoma Society Scholar. TKK received a Clinician Scientist Development Award from the American Cancer Society. The authors would like to acknowledge Kelly Norsworthy for her critical review and comments on the manuscript.

Author information

Author notes

  1. These authors contributed equally: Amer M. Zeidan, Jan Philipp Bewersdorf.

Authors and Affiliations

  1. Section of Hematology, Department of Internal Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA

    Amer M. Zeidan & Stephanie Halene

  2. Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jan Philipp Bewersdorf & Omar Abdel-Wahab

  3. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada

    Rena Buckstein

  4. Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA

    Mikkael A. Sekeres, Maria E. Figueroa, Stephen D. Nimer & Justin Taylor

  5. Novartis Institutes for BioMedical Research, Cambridge, MA, USA

    David P. Steensma

  6. Leipzig University Hospital, Leipzig, Germany

    Uwe Platzbecker

  7. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Sanam Loghavi

  8. Blood Cancer UK Molecular Haematology Unit, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, UK

    Jacqueline Boultwood

  9. Division of Hematology and Oncology, Moores Cancer Center, UC San Diego, La Jolla, CA, USA

    Rafael Bejar

  10. Hematopathology Division, Departments of Pathology and Medicine, University of Rochester Medical Center, Rochester, NY, USA

    John M. Bennett

  11. Division of Hematology, Department of Internal Medicine, James Cancer Center, Ohio State University, Columbus, OH, USA

    Uma Borate

  12. Leukemia Program, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA

    Andrew M. Brunner

  13. Leukemia Program, Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA

    Hetty Carraway

  14. Department of Hematology, Oncology, and Palliative Care, Carbone Cancer Center, The University of Wisconsin-Madison, Madison, WI, USA

    Jane E. Churpek

  15. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Naval G. Daver

  16. Department of Biomedical Sciences, Humanitas Clinical and Research Center & Humanitas University, Milan, Italy

    Matteo Della Porta

  17. Johns Hopkins Sidney Kimmel Comprehensive Cancer Centre, Baltimore, MD, USA

    Amy E. DeZern

  18. Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy

    Fabio Efficace

  19. Hôpital Saint Louis, Paris, France

    Pierre Fenaux

  20. Division of Hematology, Department of Medicine, Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA

    Peter Greenberg

  21. Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

    Elizabeth A. Griffiths

  22. Department of Pathology, Massachusetts General Hospital, Boston, MA, USA

    Robert P. Hasserjian

  23. Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA

    Christopher S. Hourigan

  24. National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Nina Kim

  25. Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Tae Kon Kim & Michael R. Savona

  26. Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL, USA

    Rami S. Komrokji, Alan F. List, Eric Padron, David A. Sallman & Zhuoer Xie

  27. Evergrande Center for Immunologic Diseases, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA

    Vijay Kutchroo

  28. Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Richard F. Little

  29. Division of Hematology, Department of Medicine, Cancer Institute, and Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA

    Ravi Majeti

  30. Department of Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA

    Aziz Nazha

  31. The University of Chicago Medicine and University of Chicago Comprehensive Cancer Center, Chicago, IL, USA

    Olatoyosi Odenike

  32. Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Mrinal M. Patnaik

  33. Weill Cornell Medical College, New York, NY, USA

    Gail J. Roboz

  34. Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Health Research Institute La Fe, Valencia, Spain; and CIBERONC, Instituto de Salud Carlos III, Madrid, Spain

    Guillermo Sanz

  35. Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA

    Maximilian Stahl

  36. Division of Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Daniel T. Starczynowski

  37. Departments of Pathology & Laboratory Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA

    Mina Xu

  38. Peter MacCallum Cancer Centre, Royal Melbourne Hospital, University of Melbourne and Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia

    Andrew H. Wei

  39. University of Florence Medical School, Florence, Italy

    Valeria Santini

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  1. Amer M. Zeidan
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Contributions

AMZ and JPB wrote the initial draft of the manuscript and contributed equally to this study. AMZ, JPB, RB, MAS, DPS, UP, SL, AHW, and VS were involved with the conception and design of the study. All authors were involved in writing, reviewing, and editing the manuscript and approved the final version for submission.

Corresponding author

Correspondence to Amer M. Zeidan.

Ethics declarations

Competing interests

The first international workshop on MDS (iwMDS) was planned by an independent scientific steering committee of the International Consortium for MDS (icMDS). The meeting was supported by unrestricted educational grants from Gilead, Novartis, BMS, Syros, Geron, and Karyopharm to Magdalen Medical/VJHemOnc. The participants met in Miami, FL in June 2022, and deliberated the content of this manuscript, which was subsequently finalized after the meeting. The meeting sponsors had no involvement in the development of this manuscript. AN, DPS, RB, AFL, CSH, and NK, and all other authors authored this manuscript in their personal capacity and their views do not necessarily represent/reflect that of their employers. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. MMP, EP, UP, RB, and SL were authors on WHO classification. RPH was co-chair of Pathology International Consensus Classification (ICC) and co-leader of ICC Pre-malignant Clonal Cytopenias and Myelodysplastic Syndromes working group. OO, MRS, and AHW were authors on the ICC classification. AMZ received research funding (institutional) from Celgene/BMS, Abbvie, Astex, Pfizer, Medimmune/AstraZeneca, Boehringer-Ingelheim, Cardiff oncology, Incyte, Takeda, Novartis, Aprea, and ADC Therapeutics. AMZ participated in advisory boards, and/or had a consultancy with and received honoraria from AbbVie, Otsuka, Pfizer, Celgene/BMS, Jazz, Incyte, Agios, Boehringer-Ingelheim, Novartis, Acceleron, Astellas, Daiichi Sankyo, Cardinal Health, Taiho, Seattle Genetics, BeyondSpring, Cardiff Oncology, Takeda, Ionis, Amgen, Janssen, Epizyme, Syndax, Gilead, Kura, Chiesi, ALX Oncology, BioCryst, Notable, Orum, and Tyme. AMZ served on clinical trial committees for Novartis, Abbvie, Gilead, BioCryst, Abbvie, ALX Oncology, Geron and Celgene/BMS. DPS is an employee of Novartis. Uwe Platzbecker received honoraria from BMS, Jazz Pharmaceuticals, Abbvie, Geron. The National Heart, Lung, and Blood Institute receives research funding for the laboratory of CSH from Sellas and from the Foundation of the NIH AML MRD Biomarkers Consortium. Fabio Efficace had a consultancy or advisory role for Amgen, AbbVie, Janssen, and Novartis and received research funding (institutional) from AbbVie, Amgen and Novartis; outside the submitted work. Pierre Fenaux received research funding from BMS, Abbvie, Jazz Pharmaceuticals, Novartis, and Janssen. Pierre Fenaux had a consultancy with and received honoraria from BMS, Abbvie, Jazz Pharmaceuticals, and Novartis. Maximilian Stahl consulted for Curis Oncology and Boston Consulting; served on the advisory board for Novartis and Kymera; and participated in GME activity for Novartis, Curis Oncology, Haymarket Media and Clinical care options (CCO). GS received grants/research supports (institutional) from BMS, Novartis, and Gamida Cell. RM is on the Board of Directors of CircBio, the Advisory Boards of Kodikaz Therapeutic Solutions, Syros Pharmaceuticals, and TenSixteen Bio, and is an inventor on a number of patents related to CD47 cancer immunotherapy licensed to Gilead Sciences. RM receives research support from Gilead Sciences and CircBio. RM is a co-founder and equity holder of CircBio, Pheast Therapeutics, MyeloGene, and RNAC Therapeutics. GS received honoraria, advisory board membership or consultation fees from AbbVie, BMS, Novartis, Roche, and Takeda and participated in sponsored speaker’s bureau for BMS, Novartis, and Takeda. AN owns stock at Amazon and is an employee of Incyte Pharmaceuticals. Olatoyosi Odenike has served on the advisory board of Bristol-Myers Squibb, Celgene, Novartis, Taiho and Kymera Therapeutics; serves on a DSMB for Threadwell Therapeutics and received research funding (institutional) from ABBVIE, Agios, aprea, Astex, Astra Zeneca, Bristol Myers Squibb, Celgene, CTI, Daiichi, Incyte, Janssen, Kartos, Novartis, NS-Pharma and Oncotherapy Sciences. DTS is a consultant and received research funding from Kymera Therapeutics, Kurome Therapeutics, Captor Therapeutics, and Tolero Therapeutics. DTS has equity in Kurome Therapeutics. DAS served on the advisory board of Aprea, AvenCell, BlueBird Bio, BMS, Intellia, Kite, Novartis, Shattuck Labs, Servier, Syndax. DAS served as a consultant for AbbVie, Magenta, Molecular Partners AG, Takeda and on the speakers’ bureau for BMS, Incyte, Servier; DAS received research funding from Aprea, Jazz. Mrinal Patnaik received research funding from Kura Oncology and StemLine Pharmaceuticals. AB received consulting or advisory board honoraria from Novartis, Acceleron, Agios, Abbvie, Takeda, Celgene/BMS, Keros Therapeutics, Taiho, Gilead. AB has research support from the NIH SPORE in Myeloid Malignancies, and from the Edward P. Evans Foundation. EP receives research funding from Incyte and BMS and honoraria from stemline, Taiho, Blueprint, and BMS. TKK received research funding from Nextcure and is a consultant for Agenus. RSK served on the speaker bureau of JAZZ, Servio, CTI, pharmaEssentia. RSK served on advisory boards and received honoraria from BMS, Novartis, Abbvie, JAZZ, servio, pharmaEssentia, Taiho, Geron, CTI. MAS has served on advisory boards for BMS, Novartis, Kurome, and Gilead. RB is employed by and has equity in Aptose Biosciences. RB serves on independent drug monitoring committees for Gilead and Epizyme. RPH has a consultancy with Bluebird Bio. Gail J. Roboz has a consultancy and/or serves on the advisory Board or Data and Safety Monitoring Committee for AbbVie, Amgen, Astellas, AstraZeneca, Bristol Myers Squibb, Blueprint Medicines, Bluebird Bio, Celgene, Glaxo SmithKline, Janssen, Jasper Therapeutics, Jazz, Mesoblast, Novartis, Pfizer, Syndax, Takeda. GR received research support from Janssen. Stephanie Halene received honoraria from FORMA Therapeutics. Andrew H.Wei has served on advisory boards for Novartis, Astra Zeneca, Astellas, Janssen, Amgen, Roche, Pfizer, Abbvie, Servier, Gilead, BMS, Shoreline, Macrogenics and Agios; receives research funding to the Institution from Novartis, Abbvie, Servier, Janssen, BMS, Syndax, Astex, Astra Zeneca, Amgen; serves on speaker’s bureaus for Abbvie, Novartis, BMS, Servier, Astellas; Andrew H.Wei is an employee of the Walter and Eliza Hall Institute (WEHI) and is eligible for financial benefits associated with payments which WEHI receives in relation to venetoclax. Alan List is employed by and has equity in Precision BioSciences, and has served as a consultant for Halia Therapeutics, CTI Biopharma, Aileron. Mina Xu participated in advisory boards and/or had a consultancy with and received honoraria from Seattle Genetics, Pure Marrow and Blueprint Medicines. ND has received research funding from Daiichi-Sankyo, Bristol-Myers Squibb, Pfizer, Gilead, Sevier, Genentech, Astellas, Daiichi-Sankyo, Abbvie, Hanmi, Trovagene, FATE therapeutics, Amgen, Novimmune, Glycomimetics, Trillium, and ImmunoGen and has served in a consulting or advisory role for Daiichi-Sankyo, Bristol-Myers Squibb, Arog, Pfizer, Novartis, Jazz, Celgene, AbbVie, Astellas, Genentech, Immunogen, Servier, Syndax, Trillium, Gilead, Amgen, Shattuck labs, and Agios. SL received research support from Astellas, Amgen; owns stock from Abbvie, and has received consultancy fees/honoraria from Abbvie, Gerson Lehrman Group, QualWorld, Guidepoint. EAG received honoraria from Abbvie, Alexion Pharmaceuticals, Genentech, Novartis, CTI biopharma, Apellis, Celgene/BMS, Takeda Oncology, Taiho Oncology, Physician Educational Resource, MediCom Worldwide, American Society of Hematology, Picnic Health, AAMDSIF and research support (institutional) from Astex Pharmaceuticals, Genentech, Blueprint Medicine, Alexion Pharmaceuticals, Apellis, BMS/Celgene, Celldex Therapeutics. MS serves on a Board or Advisory Committee for Abbvie, Bristol Myers Squibb, CTI, Forma, Geron, Karyopharm, Novartis, Ryvu, Sierra Oncology, Taiho, Takeda, TG Therapeutics, receives research funding from ALX Oncology, Astex, Incyte, Takeda, TG Therapeutics; and has equity ownership: Karyopharm, Ryvu. OA-W has served as a consultant for H3B Biomedicine, Foundation Medicine Inc, Merck, Prelude Therapeutics, and Janssen, and is on the Scientific Advisory Board of Envisagenics Inc., AIChemy, Harmonic Discovery Inc., and Pfizer Boulder; OA-W has received prior research funding from H3B Biomedicine and LOXO Oncology unrelated to the current manuscript. All other authors have no conflicts of interest to disclose.

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Zeidan, A.M., Bewersdorf, J.P., Buckstein, R. et al. Finding consistency in classifications of myeloid neoplasms: a perspective on behalf of the International Workshop for Myelodysplastic Syndromes. Leukemia 36, 2939–2946 (2022). https://doi.org/10.1038/s41375-022-01724-9

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