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IBC 2025 | Distinguishing CCUS & MDS: the importance of refining diagnostic criteria
Sanam Loghavi, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, comments on the spectrum of disease between clonal cytopenia of uncertain significance (CCUS) and myelodysplastic syndromes (MDS), highlighting that despite clinical practice distinctions based on morphologic dysplasia, the boundaries between the two are subjective. Dr Loghavi suggests refining diagnostic criteria. This interview took place at the 3rd Intercepting Blood Cancers (IBC) Workshop held in Nice, France.
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Transcript
I think the main emphasis of my talk, you know, if there’s one message that I would like people to take away is that clonal cytopenia of uncertain significance or CCUS and myelodysplastic syndrome or MDS are really a spectrum of disease and there’s really no sharply defining boundaries between the two despite what we do in clinical practice. So as you know, in clinical practice, really the distinguishing feature between CCUS and MDS is the presence or absence of morphologic dysplasia...
I think the main emphasis of my talk, you know, if there’s one message that I would like people to take away is that clonal cytopenia of uncertain significance or CCUS and myelodysplastic syndrome or MDS are really a spectrum of disease and there’s really no sharply defining boundaries between the two despite what we do in clinical practice. So as you know, in clinical practice, really the distinguishing feature between CCUS and MDS is the presence or absence of morphologic dysplasia. And I think, you know, because determining whether there’s dysplasia or not is really a subjective finding, particularly in the case of very mild morphologic dysplasia. And because we have better and more sensitive techniques now for detecting clonality and for detecting potential phenotypic abnormalities using methods other than morphology such as flow cytometry, it’s probably time that we refine the criteria for diagnostics and perhaps take into account some of the other phenotypic abnormalities other than just morphology and also the trend of disease, trend of cytopenias, the degree of cytopenias, in determining whether a patient really has functional MDS despite the fact of, you know, despite the presence or absence of morphologic dysplasia.
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