Clinical application and proposal for modification of the International Working Group (IWG) response criteria in myelodysplasia.
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.
Cheson
Bruce D
BD
Department of Hematology/Oncology, Georgetown University Hospital, Washington, DC, USA.
Greenberg
Peter L
PL
Bennett
John M
JM
Lowenberg
Bob
B
Wijermans
Pierre W
PW
Nimer
Stephen D
SD
Pinto
Antonio
A
Beran
Miloslav
M
de Witte
Theo M
TM
Stone
Richard M
RM
Mittelman
Moshe
M
Sanz
Guillermo F
GF
Gore
Steven D
SD
Schiffer
Charles A
CA
Kantarjian
Hagop
H
D006801:Humans; D009190:Myelodysplastic Syndromes / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D012074:Remission Induction; D016896:Treatment Outcome