MDS subtype associated with poor outcomes after venetoclax-based therapy
MD Anderson Research Highlight August 05, 2025
Myelodysplastic syndromes (MDS) are a group of diseases in which the bone marrow does not produce enough healthy blood cells. The erythroid predominance (EP) subtype, marked by 50% or more erythroid cells (red blood cell precursors) in the bone marrow, has distinct biology, prognoses and drug sensitivities. To study this, researchers led by , evaluated an MDS cohort of 371 patients, 18% of whom had EP MDS. They discovered EP MDS has unique genetic patterns and a high frequency of mutations in the TP53 gene. EP MDS was associated with more aggressive disease, inferior responses and poor survival rates after treatment with the BCL2 inhibitor venetoclax. The results indicate that venetoclax resistance may be associated with higher levels of the BCL-XL protein. The researchers characterized three genetic subgroups within EP MDS, each with different survival outcomes. These findings suggest that monitoring bone marrow erythroid cells can benefit patients with MDS and highlight the need for treatments targeting BCL-XL in these patients. Learn more in .
This study enhances our understanding of how erythroid predominance influences MDS behavior and response to novel therapies, and it sheds light intoon novel possible treatment avenues for these patients.