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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 | Next Article 
Submitted October 18, 2005
Accepted March 5, 2006
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*
Department of Hematology/Oncology, Georgetown University Hospital, Washington, DC, USA
Stanford University Cancer Center, Stanford, CA, USA
James P. Wilmot Cancer Center at the University of Rochester Medical Center, Rochester, NY, USA
Eramus University Medical Center, Rotterdam, The Netherlands
Ziekenhuis, The Hague, The Netherlands
Centro di Riferimento Oncologico, Aviano, Italy
Memorial Sloan-Kettering Cancer Center, New York, NY, USA
Department of Leukemia, University of Texas M. D. Anderson Cancer, Houston, TX, USA
Department of Hematology, Radboud University Nijmegen Medical Centre Central, Nijmegen, The Netherlands
Dana Farber Cancer Institute, Boston, MA, USA
Department of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv University, Sackler School of Medicine, Tel-Aviv, Israel
Hospital Universitario La Fe, Valencia, Spain
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
Karmanos Cancer Center, Wayne State University, Detroit, MI, USA
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
* Corresponding author; email: hkantarj{at}mdanderson.org.
The myelodysplastic syndromes (MDS) 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 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. As 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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