What is the prognostic implication of somatic IDH mutations in MDS?

FAQ Library published on December 6, 2018
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Jae Park, MD
Assistant Attending Physician
Division of Hematologic Oncology
Leukemia Service
Director, Adult Acute Lymphoblastic Leukemia
Memorial Sloan Kettering Cancer Center
New York, New York 
What is the prognostic implication of somatic IDH mutations in MDS?

Welcome to Managing MDS, I am Dr. Jae Park. Today, I would like to discuss the prognostic implication of somatic IDH mutations in MDS. The prognostic impact of IDH remains controversial in AML, where the mutations are more frequent than in MDS. The prognostic implication for IDH mutations may depend on specific IDH point mutations (such as IDH1 versus IDH2); even among IDH2 where there is R140 versus R172; and whether these mutations co-occur with other mutations such as NPM1. Data in this area is somewhat conflicting. It is somehow unclear whether these may represent a worse or favorable prognosis. However, the prognostic implications of IDH mutations in MDS are a little bit clearer, and these IDH mutations are consistently associated with negative prognostic markers in MDS. However, these negative prognostic indications may depend on overall prognostic risk status, and the IDH mutations may carry a greater prognostic implication for those with intermediate risk, as opposed to high-risk groups. Because these mutations can have a prognostic implication, especially for the intermediate risk groups where the treatment decisions are often made, testing for IDH1 and IDH2 mutations should be part of a routine molecular assessment. Thank you for viewing this activity.

Last modified: November 6, 2018
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