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Blood, 15 July 2006, Vol. 108, No. 2, pp. 419-425.
Prepublished online as a Blood First Edition Paper on April 11, 2006; DOI 10.1182/blood-2005-10-4149.
 Previous Article | Table of Contents | Next Article 
PERSPECTIVES
Clinical application and proposal for modification of the International Working Group (IWG) response criteria in myelodysplasia
Bruce D. Cheson,
Peter L. Greenberg,
John M. Bennett,
Bob Lowenberg,
Pierre W. Wijermans,
Stephen D. Nimer,
Antonio Pinto,
Miloslav Beran,
Theo M. de Witte,
Richard M. Stone,
Moshe Mittelman,
Guillermo F. Sanz,
Steven D. Gore,
Charles A. Schiffer, and
Hagop Kantarjian
From the Department of Hematology/Oncology, Georgetown University Hospital, Washington, DC; the Stanford University Cancer Center, CA; the James P. Wilmot Cancer Center at the University of Rochester Medical Center, NY; the Erasmus University Medical Center, Rotterdam, The Netherlands; the Ziekenhuis, Leynburg, The Hague, The Netherlands; the Centro di Riferimento Oncologico, Aviano, Italy; the Memorial Sloan-Kettering Cancer Center, New York, NY; the Department of Leukemia, University of Texas, M. D. Anderson Cancer Center, Houston; the Department of Hematology, Radboud University Nijmegen Medical Centre Central, Nijmegen, The Netherlands; the Dana-Farber Cancer Institute, Boston, MA; the Department of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel; the Hospital Universitario La Fe, Valencia, Spain; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; the Karmanos Cancer Center, Wayne State University, Detroit, MI; and the Department of Leukemia, The University of Texas, M. D. Anderson Cancer Center, Houston.
Abstract
The myelodysplastic syndromes (MDSs) are heterogeneous with respect to clinical characteristics, pathologic features, and cytogenetic abnormalities. This heterogeneity is a challenge for evaluating response to treatment. Therapeutic trials in MDS have used various criteria to assess results, making cross-study comparisons problematic. In 2000, an International Working Group (IWG) proposed standardized response criteria for evaluating clinically significant responses in MDS. These criteria included measures of alteration in the natural history of disease, hematologic improvement, cytogenetic response, and improvement in health-related quality of life. The relevance of the response criteria has now been validated prospectively in MDS clinical trials, and they have gained acceptance in research studies and in clinical practice. Because limitations of the IWG criteria have surfaced, based on practical and reported experience, some modifications were warranted. In this report, we present recommendations for revisions of some of the initial criteria.
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