Komrokji on the Classification of MDS


Rami Komrokji, MD, discusses the different systems of classifying myelodysplastic syndrome.

Rami Komrokji, MD, vice chair of the Department of Malignant Hematology and head of the Leukemia and MDS Section at Moffitt Cancer Center in Tampa, Florida, discusses the different systems of classifying myelodysplastic syndrome (MDS) and how combining the current classification systems into 1 may provide more benefit for clinicians and their patients.

Many subtypes of MDS exist and are determined using results of blood and bone marrow tests. According to Komrokji, the French-American-British (FAB) classification system was the first to determine MDS subtype, followed by the World Health Organization (WHO) classification system and the International Consensus Classification (ICC) system.


0:08 | As you know, the classification for MDS has been evolving over the years, from FAB back in the 80s, to different iterations from the WHO. But it is the first time where we have actually 2 classifications. So we have the WHO and the ICC. I think both of them are an attempt to improve the classification for MDS, but also, it creates a little bit of a dilemma in the field controversy on which one to follow. There are some differences, so I think it was important to try to generate data driven evidence to guide us, hopefully for future harmonization of those 2 classifications.

0:47 | I think people are mixing a lot with classification vs prognostic models, so the risk stratification and MDS is based on revised IPSS-M. The classification historically is pathological classification. I think it should reflect the unique biology of the disease, a unique group that has certain clinical phenotypes, maybe the pathogenesis of defective hematopoiesis is similar in that group. That's what we were trying to do, really validate those and hopefully this is the first step of trying to come up with harmonization and 1 classification back in MDS.

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