Myelodysplastic Syndrome

P2, N=30, Not yet recruiting, Stanford University

P2, N=25, Completed, H. Lee Moffitt Cancer Center and Research Institute | Active, not recruiting --> Completed

P2, N=150, Recruiting, University Hospital, Clermont-Ferrand | Trial completion date: Dec 2027 --> May 2030 | Trial primary completion date: Oct 2026 --> May 2030

P1/2, N=249, Active, not recruiting, Molecular Partners AG | Recruiting --> Active, not recruiting | Trial completion date: Dec 2029 --> May 2027 | Trial primary completion date: Dec 2027 --> May 2026

P=N/A, N=50, Not yet recruiting, The First Affiliated Hospital of Soochow University

P2, N=10, Active, not recruiting, M.D. Anderson Cancer Center | Recruiting --> Active, not recruiting | N=40 --> 10

Given the differing cytogenetics among each cell population, the CLL and AML may have developed as separate clonal processes. With a further understanding of the pathogenic mechanism, this may influence the treatment decision-making process.

Lastly, an exploratory cross-disease comparison showed that MRD-negative (MRDneg) hrMDS patients had similar survival outcomes to MRD-positive (MRDpos) AML patients. These findings demonstrate the prognostic value of MFC-MRD in intensively treated hrMDS and provide rationale for prospective trials of MRD-informed transplant and post-remission strategies.

Pretransplant treatment was intentionally limited to 2-3 cycles: three cycles of Aza in Case 1, intensive induction chemotherapy followed by one cycle of Aza in Case 2, and two cycles of venetoclax plus Aza in Case 3. In addition, for patients with FISH-detectable TP53 abnormalities, serial FISH may provide a practical adjunct for pretransplant decision-making in routine practice. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.

Despite standard induction and intrathecal chemotherapy, bone marrow assessment demonstrated primary refractory disease. This case highlights aggressive secondary AML with adverse biology, CNS involvement, and induction failure.

After ruxolitinib therapy, he later developed leukocytosis and 2% circulating blasts. Repeat marrow demonstrated ≥ 15% ring sideroblasts. Retrospectively, the initial biopsy fulfills ICC 2022 criteria for MDS/MPN-SF3B1-T, highlighting the diagnostic value of genetics-integrated classification in fibrotic marrows.

DLI is an effective treatment strategy for post-transplant relapse of all myeloid malignancies, with specific genetic subtypes showing poorer outcomes and survival.