Review ArticlesUpdates in Risk Stratification in Myelodysplastic SyndromesAguirre, Luis E. MD; Sallman, David A. MD; Stone, Richard MD; Komrokji, Rami S. MD Author Information From the H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Reprints: Luis E. Aguirre, MD, Moffitt Cancer Center, Magnolia Campus, 12902 USF Magnolia Dr, Tampa, FL 33612. E-mail: [email protected]; Rami S. Komrokji, MD, Moffitt Cancer Center, Magnolia Campus, 12902 USF Magnolia Dr, Tampa, FL 33612. E-mail: [email protected]. The Cancer Journal 29(3):p 138-142, 5/6 2023. | DOI: 10.1097/PPO.0000000000000654 Buy Metrics Abstract Risk stratification plays an essential role in treatment planning in myelodysplastic syndromes. For decades, the International Prognostic Scoring System and its revised version have provided unified consensus for clinical trial enrollment and design. These models relied on laboratory and cytogenetic data to estimate prognosis and dictate treatment paradigms. Critical developments in DNA sequencing techniques in recent years, as well as our growing understanding of the clonal dynamics of myelodysplastic syndromes and the role that specific mutations have in shaping disease-specific phenotypes and treatment susceptibilities, have made it possible to identify molecular markers that carry critical diagnostic and therapeutic relevance and remained unaccounted for in the older models. The Molecular International Prognostic Scoring System is a novel risk stratification model that integrates clinical, cytogenetic, and molecular data to devise a more refined prognostic tool that builds on the accuracy of the traditional models. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.