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Hebeda, K; Boudova, L; Beham-Schmid, C; Orazi, A; Kvasnicka, HM; Gianelli, U; Tzankov, A.
Progression, transformation, and unusual manifestations of myelodysplastic syndromes and myelodysplastic-myeloproliferative neoplasms: lessons learned from the XIV European Bone Marrow Working Group Course 2019.
Ann Hematol. 2021; 100(1):117-133 Doi: 10.1007/s00277-020-04307-9 (- Case Report)
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Beham-Schmid Christine
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Abstract:
Disease progression in myelodysplastic syndromes (MDS) and myelodysplastic-myeloproliferative neoplasms (MDS/MPN) is a major source of mortality. The European Bone Marrow Working Group organized a dedicated workshop to address MDS and MDS/MPN progression, and myeloid neoplasms with histiocytic and lymphoblastic outgrowths in 2019 in Frankfurt, Germany. In this report, we summarize clinical, histopathological, and molecular features of 28 cases. Most cases illustrate that prognostic mutational profiles change during follow-up due to accumulation of high-risk mutations in the trunk clone, and that results from repeated molecular testing can often explain the clinical progression, suggesting that regular genetic testing may predict transformation by early detection of aggressive clones. Importantly, identical mutations can be linked to different clinical behaviors or risks of fibrotic progression and/or transformation in a context-dependent manner, i.e., MDS or MDS/MPN. Moreover, the order of mutational acquisition and the involved cell lineages matter. Several cases exemplify that histiocytic outgrowths in myeloid neoplasms are usually accompanied by a more aggressive clinical course and may be considered harbinger of disease progression. Exceptionally, lymphoblastic transformations can be seen. As best estimable, the histiocytic and lymphoblastic compounds in all occasions were clonally related to the myeloid compound and-where studied-displayed genomic alterations of, e.g., transcription factor genes or genes involved in MAPK signaling that might be mechanistically linked to the respective type of non-myeloid outgrowth.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent -
Adult -
Aged -
Aged, 80 and over -
Bone Marrow - pathology
Cell Transformation, Neoplastic - genetics
Cell Transformation, Neoplastic - pathology
Disease Progression -
Education - methods
Education -
Female -
Female -
Humans -
Male -
Middle Aged -
Myelodysplastic Syndromes - genetics
Myelodysplastic Syndromes - pathology
Myelodysplastic-Myeloproliferative Diseases - genetics
Myelodysplastic-Myeloproliferative Diseases - pathology

Find related publications in this database (Keywords)
Histiocytic transformation
Lymphoblastic
MDS
MDS
MPN
Mutations
Myeloid neoplasm
Progression
Transformation
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