The article “Therapy-related myelodysplastic syndromes deserve specific diagnostic sub-classification and risk-stratification-an approach to classification of patients with t-MDS” is the result of the work of the worldwide group of Myelodysplastic Syndromes coordinated by Ulrich Germing (Heinrich-Heine-Universität Düsseldorf), Detlef Haase (Universitätklinikum Göttingen), Peter Greenberg (Stanford MDS Center), Guillermo Sanz (Hospital Universitario y Politécnico La Fe) and Francesc Solé.

The International Work Group for Prognosis in MDS (IWG-PM) has previously generated the revised IPSS-R prognostic stratification system for MDS and is currently evaluating the impact of molecular mutations on the prognosis, what would be named the IPSS-M (molecular).

The current WHO classification (2017) proposes the entity "Therapy related myeloid neoplasms (TRMN)" or therapy related myeloid neoplasms, which encompasses acute myeloblastic leukemias (AML), MDS and MDS/myeloproliferative neoplasms (MDS/MPN) secondary to a previous neoplasm and treatment. In the present work, based on a database of patients from IWG-PM centers, clinical and biological characteristics from patients with the diagnosis of secondary MDS are compared with primary or de novo MDS. The results suggest that within the NRT entity, 3 groups should be made, secondary AML, secondary MDS/MPN and secondary MDS, since they are diseases with different clinical and biological characteristics. These results are the basis for a second study led by Detlef Haase and Francesc Solé, which aims to correlate cancer and previous treatment with cytogenetic changes.