Clinical and molecular characteristics of patient A and patient B and treatment decisions
| . | Time of diagnosis . | After 6 months of follow-up . | ||
|---|---|---|---|---|
| . | Patient A . | Patient B . | Patient A . | Patient B . |
| Age | 72 y | 71 y | 72 y | 72 y |
| Performance status by KS | >80% | >80% | >80% | >80% |
| Comorbidities by HCT-CI | Low | Low | Low | Low |
| ANC × 109/L | 0.78 | 1.5 | 1 | 1.8 |
| Hb g/dL | 8.2 | 8 | 8.1 | 8.3 |
| PLT × 109/L | 135 | 95 | 167 | 91 |
| % of marrow blasts | 4 | 3 | 4 | 3 |
| Cytogenetics by IPSS-R | Normal karyotype (good risk) | Normal karyotype (good risk) | Isolated del(7q) (intermediate risk) | Normal karyotype (good risk) |
| Gene mutations (VAF) | TP53 (5%) | TET2 (43%), SRSF2 (31%) | Additional TP53 (4%) | TET2 (42%), SRSF2 (32%) |
| IPSS-R risk | Intermediate | Intermediate | Intermediate | Intermediate |
| IPSS-M risk | Moderate low | Moderate low | Very high | Moderate low |
| Treatment decision | Watch and wait; consider ESA if moderate to severe anemia persists | Watch and wait; consider ESA if moderate to severe anemia persists | HSCT up-front | To continue ESA |
| . | Time of diagnosis . | After 6 months of follow-up . | ||
|---|---|---|---|---|
| . | Patient A . | Patient B . | Patient A . | Patient B . |
| Age | 72 y | 71 y | 72 y | 72 y |
| Performance status by KS | >80% | >80% | >80% | >80% |
| Comorbidities by HCT-CI | Low | Low | Low | Low |
| ANC × 109/L | 0.78 | 1.5 | 1 | 1.8 |
| Hb g/dL | 8.2 | 8 | 8.1 | 8.3 |
| PLT × 109/L | 135 | 95 | 167 | 91 |
| % of marrow blasts | 4 | 3 | 4 | 3 |
| Cytogenetics by IPSS-R | Normal karyotype (good risk) | Normal karyotype (good risk) | Isolated del(7q) (intermediate risk) | Normal karyotype (good risk) |
| Gene mutations (VAF) | TP53 (5%) | TET2 (43%), SRSF2 (31%) | Additional TP53 (4%) | TET2 (42%), SRSF2 (32%) |
| IPSS-R risk | Intermediate | Intermediate | Intermediate | Intermediate |
| IPSS-M risk | Moderate low | Moderate low | Very high | Moderate low |
| Treatment decision | Watch and wait; consider ESA if moderate to severe anemia persists | Watch and wait; consider ESA if moderate to severe anemia persists | HSCT up-front | To continue ESA |
ANC, absolute neutrophil count; ESA, erythropoiesis stimulating agents; Hb, hemoglobin; HCT-CI, HSCT-specific comorbidity index; IPSS-M, Molecular International Prognostic Scoring System; IPSS-R, Revised International Prognostic Scoring System; KS, Karnofsky scale; PLT, platelet; VAF, variant allele frequency.