ASH 2025 | The prognostic significance of achieving mCR with hypomethylating agent-based therapy in MDS

Sure, yeah. So I think this gets back to the old working group criteria, the 2006 working group criteria. One main change between the 2006 and the updated 2023 working group criteria is that we got rid of the response category of marrow CR. And marrow CR, in essence, means that you clear leukemia cells, so your blasts are less than 5%, but you do not have adequate blood count recovery. And there was always a thought that this is not really associated with a survival benefit or a long-term benefit for patients. What we showed in this presentation by my fellow Benjamin Rolles is to look at Marrow CR as defined by 2006. And what we find is that, particularly in the patients who do not go to transplant, the outcomes were not any better than patients who did not have a response to therapy. In a second step, what Benjamin did, he recoded the marrow CR response criteria based on the 2023 response criteria. And what he found is that the 2023 response criteria can actually differentiate outcomes for those patients with marrow CR quite nicely. So patients with marrow CR who are coded to have CR with unilineage or bilineage count recovery had better outcomes than those patients who did not have a CR with limited count recovery by IWG-2023. And I think this again shows that the new response criteria are really the way we should assess response in those patients.

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