The new guidelines will help haematologists identify which patients could potentially respond to specific types of therapies, and also better categorise patients based on their type of immune response (autoimmune versus autoinflammatory) which affect the choice of therapy and clinical outcome. The recommendations have been endorsed by the European Haematology Association (EHA), which has also awarded further funding (Innovation Grant 2024) over a two-year period to test their feasibility and accuracy. This grant was awarded during the opening ceremony of EHA 2024 congress in Madrid, Spain.
The guidelines were created by the International Integrative Immunology for MDS (i4MDS) – an international consortium created and led by Dr Shahram Kordasti, Reader and Group Leader in Applied Cancer Immunopathology. The consortium aims to utilise international expertise to foster a deeper understanding of the immune mechanisms underlying MDS. This, in turn, will aid efforts in drug development towards its treatment.
MDS are a group of cancers in which immature blood cells in the bone marrow do not mature or become healthy blood cells. Instead of developing normally, the blood cells die in the bone marrow or just after entering the bloodstream.
People over the age of 60 are at increased risk of MDS, and the prevalence of these diseases is growing due to a rapidly ageing population worldwide. There are various risks associated with MDS, including increased likelihood of infections, anaemia and bleeding and bruising. MDS can also progress to Acute Myeloid Leukaemia (AML), which is a more aggressive and difficult-to-treat form of leukaemia.
Immunotherapy is a powerful tool that has been effective against several cancers, such as lung and skin cancers. It harnesses the body’s immune system and directs it to fight cancer cells.
The role of the immune system in the pathophysiology of MDS is firmly established. However, routine immune monitoring for these patients is still not a common practice. Furthermore, a universally accepted protocol for which components of the immune system should be monitored had not been agreed upon.
The new guidelines give recommendations around flow cytometry, a powerful analytical tool used to measure and analyse the physical and chemical characteristics of individual cells as they flow through a beam of light. In flow cytometry, ‘panels’ refer to groups of specific antibodies used to detect and measure various cellular markers that can characterise different cell populations. The new guidelines give recommendations for seven panels for measuring immune response in MDS.