title: Clinical application and proposal for modification of the International Working Group (IWG) response criteria in myelodysplasia.
abstract: The myelodysplastic syndromes (MDSs) are heterogeneous with respect to clinical characteristics, pathologic features, and cytogenetic abnormalities. This heterogeneity is a challenge for evaluating response to treatment. Therapeutic trials in MDS have used various criteria to assess results, making cross-study comparisons problematic. In 2000, an International Working Group (IWG) proposed standardized response criteria for evaluating clinically significant responses in MDS. These criteria included measures of alteration in the natural history of disease, hematologic improvement, cytogenetic response, and improvement in health-related quality of life. The relevance of the response criteria has now been validated prospectively in MDS clinical trials, and they have gained acceptance in research studies and in clinical practice. Because limitations of the IWG criteria have surfaced, based on practical and reported experience, some modifications were warranted. In this report, we present recommendations for revisions of some of the initial criteria.
authors.affiliation: Department of Hematology/Oncology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Cheson
authors.forename: Peter L
authors.initials: PL
authors.lastname: Greenberg
authors.forename: John M
authors.initials: JM
authors.lastname: Bennett
authors.forename: Bob
authors.initials: B
authors.lastname: Lowenberg
authors.forename: Pierre W
authors.initials: PW
authors.lastname: Wijermans
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Nimer
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.forename: Miloslav
authors.initials: M
authors.lastname: Beran
authors.forename: Theo M
authors.initials: TM
authors.lastname: de Witte
authors.forename: Richard M
authors.initials: RM
authors.lastname: Stone
authors.forename: Moshe
authors.initials: M
authors.lastname: Mittelman
authors.forename: Guillermo F
authors.initials: GF
authors.lastname: Sanz
authors.forename: Steven D
authors.initials: SD
authors.lastname: Gore
authors.forename: Charles A
authors.initials: CA
authors.lastname: Schiffer
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
mesh_terms: D006801:Humans; D009190:Myelodysplastic Syndromes / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D012074:Remission Induction; D016896:Treatment Outcome