Risk stratification in myelodysplastic syndromes: is there a role for gene expression profiling?

Abstract

Evaluation of: Pellagatti A, Benner A, Mills KI et al. Identification of gene expression-based prognostic markers in the hematopoietic stem cells of patients with myelodysplastic syndromes. J. Clin. Oncol. 31(28), 3557–3564 (2013).

Patients with myelodysplastic syndromes (MDS) exhibit wide heterogeneity in clinical outcomes making accurate risk-stratification an integral part of the risk-adaptive management paradigm. Current prognostic schemes for MDS rely on clinicopathological parameters. Despite the increasing knowledge of the genetic landscape of MDS and the prognostic impact of many newly discovered molecular aberrations, none to date has been incorporated formally into the major risk models. Efforts are ongoing to use data generated from genome-wide high-throughput techniques to improve the ‘individualized’ outcome prediction for patients. We here discuss an important paper in which gene expression profiling (GEP) technology was applied to marrow CD34⁺ cells from 125 MDS patients to generate and validate a standardized GEP-based prognostic signature.

Keywords::

• gene expression profiling
• international prognostic scoring system
• myelodysplastic syndromes
• prognostication
• risk stratification

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Accurate risk stratification is a vital component of the risk-adaptive management paradigm for myelodysplastic syndromes (MDS).

• Current prognostic schemes for MDS rely on clinicopathological parameters.

• Despite the increasing knowledge of the prognostic impact of molecular aberrations in MDS, none has yet been incorporated into the major risk models.

• Genome-wide high-throughput techniques, including gene expression profiling, have the potential to improve the ‘individualized’ outcome prediction for MDS patients.