Risk Stratification and Treatment Strategies for High-Risk Myelodysplastic Syndromes
Rami Komrokji, MD, Moffitt Cancer Center, Tampa, Florida, shares updates on risk stratification tools for the classification of myelodysplastic syndromes (MDS), utilization of treatments prior to allogeneic stem cell transplantation, and the latest standard of care for patients with high-risk MDS at the 2025 Lymphoma, Leukemia & Myeloma (LL&M) Winter Symposium in Miami, Florida.
Transcript:
Hi, I am Rami Komrokji. I'm the Vice Chair of Malignant Hematology Department at the Moffitt Cancer Center in Tampa, Florida. I'm excited to be here at the LL&M Winter meeting, appropriately held in Miami, and looking forward for the meeting.
My talk today is summarizing updates in managing higher-risk myelodysplastic syndromes. I think obviously we are better nowadays in defining what is higher-risk MDS. We've had a couple of updates on the classification for MDS, the risk stratification tools where now we incorporate molecular data in risk stratification. We are becoming better in identifying who are the patients that have higher-risk MDS, which obviously is a more life-threatening disease with higher chances to progress to acute myeloid leukemia (AML).
We'll talk about the role of allogeneic stem cell transplant treatments before transplant. Then we'll talk about the standard of care currently evolving with other agents to be used, particularly discussing the role of venetoclax that's approved for acute myeloid leukemia, where does it fit in the current management of MDS and in the future.
Then we'll talk a little bit also about some of the recent clinical trials that were conducted in higher risk myelodysplastic syndrome. To date, hypomethylating agents in their different format remain our standard of care. Also, we'll discuss a little bit on the unmet need of managing patients after hypomethylating agents’ failure, where now also we have a new approval by the FDA for an IDH1 inhibitor to be used in that setting.
In summary, it's really focusing on more how to identify patients in practice that are considered higher-risk, bridging those patients to transplant, where now we can offer transplant to a wider number of patients or larger number of patients—how to prepare those patients for transplant, how to manage patients that are not candidates for transplant, and what to do after hypomethylating agents fail.
Source:
Komrokji R. Updates in High-Risk Myelodysplastic Syndromes. Presented at Lymphoma, Leukemia & Winter Symposium; February 7-9, 2025. Miami, FL.
