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EBMT 2025 | Recommendations for clinical-genomic profiling of MDS to inform alloSCT
Carmelo Gurnari, MD, University of Rome Tor Vergata, Rome, Italy, and Cleveland Clinic, Cleveland, OH, discusses a paper outlining the recommendations for clinical-genomic profiling of myelodysplastic syndromes (MDS) to inform allogeneic stem cell transplantation (alloSCT). These recommendations were made by an international panel on behalf of the EBMT, and Dr Gurnari highlights the rationale for updating the previous recommendations, published in 2017. The panel recommends considering alloSCT at diagnosis for all patients, and providing guidance on features of the disease, patient, and transplantation platforms to optimize treatment outcomes. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.
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Transcript
Last year, the last EBMT actually, so exactly one year ago, we gathered with the Chronic Malignancy Working Party and with a key speaker, key leader in the field of MDS, and we felt that the new genomic acquisitions were pressing for a new update of the 2017 recommendation from the Chronic Malignancy Working Party on myelodysplastic syndrome and allogeneic hematopoietic stem cell transplantation indications...
Last year, the last EBMT actually, so exactly one year ago, we gathered with the Chronic Malignancy Working Party and with a key speaker, key leader in the field of MDS, and we felt that the new genomic acquisitions were pressing for a new update of the 2017 recommendation from the Chronic Malignancy Working Party on myelodysplastic syndrome and allogeneic hematopoietic stem cell transplantation indications.
So we felt that it was needed an update because of the important acquisitions from a molecular and biological standpoint. In particular, we now know that up to 15% of patients with molecular information can be differently managed with the timing of transplant that can be either postponed or anticipated. And this is obviously not trivial because we are talking about one to two patients out of ten that can be differentially managed with the help of molecular information. So another thing that we felt was important was to give the indication for transplant to all eligible patients at diagnosis.
So always have in mind that the patient with the initial diagnosis of MDS, if eligible, needs to be at least considered for transplant, which is something that in the community sometimes is a gap and only 10-15% of all comers MDS can access to these curative, the only curative opportunity, just because of the demographics of the disease that typically pertains to the elderly population.
So in this paper we offer recommendations in our genomic era for diagnosing and in particular treating MDS patients eligible to transplant with regards to timing, with regards to features of the disease, features of the patient and allogeneic hematopoietic stem cell transplantation platforms.
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