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December 8, 2025Blood

Clonal evolution and risk assessment in myelodysplastic syndromes (MDS): A prospective Study of dynamic IPSS-m validation and evolutionary trajectory modeling by the italian MDS foundation (FISIM)

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Authors

DRDaniele RamazzottiMRMarco Gabriele RaddiFPFederica Pilo

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Overview

Prospective study demonstrates improved prognostic performance of dynamic IPSS-M in MDS patients for AML risk prediction.

Key Points

  • This research aims to assess the clonal evolution and risk of progression in myelodysplastic syndromes using the dynamic International Prognostic Scoring System.
  • Prospective enrollment of adult MDS patients across 28 Italian hospitals.
  • Collection of clinical and molecular data from peripheral blood and bone marrow.
  • Application of Cox regression models for validation of IPSS-M and mutation detection accuracy.
  • Improved predictive performance of dynamic IPSS-M compared to baseline assessment with c-index of 0.80 for overall survival.
  • CCF-based evolutionary modeling identified 46 recurrent mutation trajectories associated with AML.
  • TP53 and RUNX1 were significant predictors of AML evolution based on clonal dynamics.

Cite This Study

Ramazzotti et al. (2025) studied this question.

synapsesocial.com/papers/69362f4e4fa91c937236d82bhttps://doi.org/10.1182/blood-2025-3842
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