The Spanish Network of Cancer Registries (Redecan) reveals an incidence of 4.16 cases per 100,000 inhabitants per year.
The myelodysplastic syndromes (SMD) constitute a heterogeneous group of clonal hematologic cancers characterized by impaired proliferation capabilities of hematopoietic stem cells, with qualitative (or dyshemopoiesis) and quantitative (lower than normal blood cell counts or cytopenias) manifestations. These diseases present an increased risk of progress to acute myeloid leukemia (AML) and mainly affect elderly patients.
In fact, the Spanish Registry of MDS (Resmd), with more than 15 years of history, places its median age 75 years, and 80 percent of cases occur in people over 60 years of age. For its part, the Spanish Network of Cancer Registries (Redecan) reveals a incidence of 4.16 cases per 100,000 inhabitants and year, which would mean about 2,000 new cases each year.
The most relevant of recent years in the MDS approach has been “the introduction of diagnostic techniques of massive sequencing and the consequent identification of recurrent mutations in these hematological cancers”, highlights Teresa Bernalhematologist at the Central University Hospital of Asturias and coordinator of the XII Annual Meeting of the Spanish Group of SMD (Gesmd), of the Spanish Society of Hematology and Hemotherapy (SEHH).
“The genetic alterations that the hematopoietic cells of each individual predict a particular behavior of the disease and allow it to be treated differently from the rest of the patients who do not have these mutations”, explains Bernal. “The targeted therapies They will make individualized treatment possible not only for each subtype of disease, but also for each specific patient based on their genetic alterations”.
Presence and absence of alterations in 31 genes
The International Molecular Prognostic Scoring System (IPSS-M) is a prognostic index for patients with MDS that has been recently developed by the International Working Group for the MDS Prognosis (IWG-PM in its English acronym). “For the first time, molecular variables are included alongside the clinical ones,” he explains. Laura Palomobiologist at the Valle de Hebrón University Hospital (Barcelona) and also coordinator of the XII Annual Meeting of the Gesmd.
Specifically, the IPSS-M collects the presence or absence of alterations in 31 genes recurrently mutated in MDS and integrates them together with the rest of the variables. In this way, “each patient can be assigned a specific risk score in one of the six established categories: very low, low, moderate intermediate, high intermediate, high and very high”, adds Palomo.
The experts gathered at the XII Annual Meeting of the Gesmd have addressed the problem of myeloid hematological neoplasms secondary to therapy (MDS or AML) that develop in patients who have been exposed to chemotherapy or radiotherapy to treat a previous cancer. “Although they are rare, their incidence is increasing due to the higher survival rate of these patients and varies according to the type of cancer and treatment regimen,” he says. Mary Ten Campelo, hematologist at the Salamanca Assistance Complex and president of the Gesmd. These MDS usually present clinical and genetic characteristics typical of those at high risk, so “they usually have a very poor prognosis”.
Other relevant discoveries related to the MDS approachsuch as the fact that the hematopoietic microenvironment (or environment in which the blood stem cells are found in the bone marrow) “seems to contribute to the development of these hematological cancers and to the survival of the malignant cells”, the experts conclude.
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