The following is a summary of “Incorporation mutational profile might reduce the importance of blast count in prognostication of low-risk myelodysplastic syndromes,” published in the August 2024 issue of Hematology by García-Culebras et al.

The addition of molecular data to predictive models had improved risk stratification of myelodysplastic neoplasms (MDS), while the role of molecular lesions, particularly in the group of low-risk disease (LR-MDS), was uncertain.

Researchers conducted a retrospective study evaluating 227 patients with LR-MDS, where OS and the probability of leukemic progression were the primary endpoints.

They evaluated the impact of blast percentage on survival and progression in LR-MDS, considering both categorical (<5% vs. 5–9%) and continuous variable analysis.

The results showed that RUNX1 was associated with lower OS and SF3B1 with a reduced risk of death (HR: 1.7, 95% CI, 1.1–2.9; P=0.05; and HR: 0.23, 95% CI 0.1–0.5; P<0.001; respectively). The TP53 and RUNX1 mutations were predictive covariates for the probability of leukemic progression (P<0.001). Blast percentage was neither analyzed as categorical (<5% vs. 5%–9%; HR: 1.3, 95% CI, 0.7–2.9; P=0.2) nor as a continuous variable (HR: 1.07, 95% CI, 0.9–1.1; P=0.07), had an impact on survival or probability of progression (sHR: 1.05, 95% CI, 0.9–1.1; P=0.2). The results retained statistical significance when the analysis was restricted to the definition of LR-MDS according to the WHO 2022 and ICC classifications (<5% blasts).

They concluded that with the incorporation of molecular data, blast percentage lost clinical significance for survival and probability of progression in the group of patients with LR-MDS.

Source: onlinelibrary.wiley.com/doi/10.1111/bjh.19714