From ASH Meeting on Hematologic Malignancies: How would you use molecular diagnostic tests to classify patients with MDS?

Senior physician at the Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School in Boston, MA

During their presentations, MHM speakers will be asking the audience how they would respond to patient cases. Audience members will vote live at the meeting via an audience response system, but we want to know what you would do. Send in your responses for a chance to win an ASH Clinical News-themed prize!

CLINICAL DILEMMA

A 70-year-old woman is referred for a hemoglobin of 10.9 g/dL and MCV of 100 fL. Her platelet count is 140,000/µL and white blood cell count and differential are normal.

Her only medication is lisinopril, she rarely drinks alcohol, and her B12/folate levels are normal. Marrow shows occasional dysplastic erythroid precursors representing <10 percent of cells; blasts are 2 percent, and there are no ring sideroblasts. Her karyotype is 46,XX in 20/20 metaphases.

A 26-gene molecular panel shows a DNMT3A R882H mutation in 8 percent of 330 reads.

Which of the following is the best descriptor for this patient’s condition?

  1. Clonal hematopoiesis of indeterminate potential (CHIP)
  2. Idiopathic cytopenias of undetermined significance (ICUS)
  3. Clonal cytopenias of undetermined significance (CCUS)
  4. MDS with multilineage dysplasia
  5. Unclassifiable MDS

Here’s how MHM audience members and ASH Clinical News readers responded:

MHM Audience Responses

  • CHIP
  • ICUS
  • CCUS
  • MDS with multilineage dysplasia
  • Unclassifiable MDS

ASH Clinical News Reader Responses

  • CHIP
  • ICUS
  • CCUS
  • MDS with multilineage dysplasia
  • Unclassifiable MDS

Disclaimer: ASH does not recommend or endorse any specific tests, physicians, products, procedures, or opinions, and disclaims any representation, warranty, or guaranty as to the same. Reliance on any information provided in this article is solely at your own risk.

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