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The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms
SIMPLE SUMMARY: In this review, we provide a brief account of recent genomic findings, updated guidelines and emerging promising tools to help refine our diagnostic abilities in the setting of myelodysplastic neoplasms; We also discuss limitations of current practices during disease follow-up, to sh...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688198/ https://www.ncbi.nlm.nih.gov/pubmed/36428782 http://dx.doi.org/10.3390/cancers14225690 |
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author | El Hussein, Siba Loghavi, Sanam |
author_facet | El Hussein, Siba Loghavi, Sanam |
author_sort | El Hussein, Siba |
collection | PubMed |
description | SIMPLE SUMMARY: In this review, we provide a brief account of recent genomic findings, updated guidelines and emerging promising tools to help refine our diagnostic abilities in the setting of myelodysplastic neoplasms; We also discuss limitations of current practices during disease follow-up, to shed light on the pressing need to enhance our prognostic armamentarium in the near future. ABSTRACT: Until recently, conventional prognostication of myelodysplastic neoplasms (MDS) was performed using the revised International Prognostic Scoring System (IPSS-R), with additional adverse prognoses conferred by select mutations. Nonetheless, the clonal diversity and dynamics of coexisting mutations have been shown to alter the prognosis and treatment response in patients with MDS. Often in the process of clonal evolution, various initial hits are preferentially followed by a specific spectrum of secondary alterations, shaping the phenotypic and biologic features of MDS. Our ability to recapitulate the clonal ontology of MDS is a necessary step toward personalized therapy and the conceptualization of a better classification system, which ideally would take into consideration all genomic aberrations and their inferred clonal architecture in individual cases. In this review, we summarize our current understanding of the molecular landscape of MDS and the role of mutational combinations, clonal burden, and clonal hierarchy in defining the clinical fate of the disease. |
format | Online Article Text |
id | pubmed-9688198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96881982022-11-25 The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms El Hussein, Siba Loghavi, Sanam Cancers (Basel) Review SIMPLE SUMMARY: In this review, we provide a brief account of recent genomic findings, updated guidelines and emerging promising tools to help refine our diagnostic abilities in the setting of myelodysplastic neoplasms; We also discuss limitations of current practices during disease follow-up, to shed light on the pressing need to enhance our prognostic armamentarium in the near future. ABSTRACT: Until recently, conventional prognostication of myelodysplastic neoplasms (MDS) was performed using the revised International Prognostic Scoring System (IPSS-R), with additional adverse prognoses conferred by select mutations. Nonetheless, the clonal diversity and dynamics of coexisting mutations have been shown to alter the prognosis and treatment response in patients with MDS. Often in the process of clonal evolution, various initial hits are preferentially followed by a specific spectrum of secondary alterations, shaping the phenotypic and biologic features of MDS. Our ability to recapitulate the clonal ontology of MDS is a necessary step toward personalized therapy and the conceptualization of a better classification system, which ideally would take into consideration all genomic aberrations and their inferred clonal architecture in individual cases. In this review, we summarize our current understanding of the molecular landscape of MDS and the role of mutational combinations, clonal burden, and clonal hierarchy in defining the clinical fate of the disease. MDPI 2022-11-19 /pmc/articles/PMC9688198/ /pubmed/36428782 http://dx.doi.org/10.3390/cancers14225690 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review El Hussein, Siba Loghavi, Sanam The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms |
title | The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms |
title_full | The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms |
title_fullStr | The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms |
title_full_unstemmed | The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms |
title_short | The Impact of Clonal Hierarchy and Heterogeneity on Phenotypic Manifestations of Myelodysplastic Neoplasms |
title_sort | impact of clonal hierarchy and heterogeneity on phenotypic manifestations of myelodysplastic neoplasms |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688198/ https://www.ncbi.nlm.nih.gov/pubmed/36428782 http://dx.doi.org/10.3390/cancers14225690 |
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