{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:13:54Z","timestamp":1789229634500,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The acquisition of subsequent genetic lesions (clonal evolution, CE) and\/or the expansion of existing clones (CEXP) contributes to clonal dynamics (CD) in myelodysplastic syndromes (MDS). Although CD plays an important role in high\u2010risk patients in disease progression and transformation into acute myeloid leukemia (AML), knowledge about CD in lower\u2010risk MDS (LR\u2010MDS) patients is limited due to lack of robust longitudinal data considering the long clinically stable courses of the disease. In this retrospective analysis, we delineate the frequency and the prognostic impact of CD in an unselected real\u2010world cohort of LR\u2010MDS patients. We screened 68 patients with a median follow\u2010up of 40.5 months and a median of 7.5 (range: 2\u201322) timepoints for CE and CEXP detected by chromosomal banding analysis, fluorescence in situ hybridization, sequencing, and molecular karyotyping. In 30\/68 patients, 47 CE events and a CD rate of 1 event per 4 years were documented. Of note, patients with at least 1 CE event had an increased probability for subsequent treatment. Unexpectedly, CE did not correlate with inferior outcomes, which could be reasonably explained by CD detection triggering the subsequent start of a disease\u2010modifying therapy.<\/jats:p>","DOI":"10.1002\/hem3.70014","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T09:12:55Z","timestamp":1727082775000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comprehensive sequential genetic analysis delineating frequency, patterns, and prognostic impact of genomic dynamics in a real\u2010world cohort of patients with lower\u2010risk MDS"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6317-0216","authenticated-orcid":false,"given":"Paolo","family":"Mazzeo","sequence":"first","affiliation":[{"name":"Department of Hematology and Medical Oncology, INDIGHO laboratory University Medical Center G\u00f6ttingen (UMG)  G\u00f6ttingen 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