Reactive oxygen species levels decreased and patients with evident bone marrow failure showed hematological response. A study has explored the clinical impact of both mutation-based and non-mutation-based p53 dysfunction in MDS. Preclinical models show significant efficacy in combos against AML cell lines with FLT3, KMT2A, NPM1, and TP53 mutations. Mice treated with the novel approach had a “significantly lower tumor burden” compared with mice that received controls. The agent recalibrates the immune system to attack tumors and increases cancer susceptibility to standard of care therapy. A phase 3 study comparing the treatments in multiple hematologic malignancies also saw greater overall survival at one year. Imetelstat is indicated for patients with lower-risk MDS who had an unsatisfactory response to or are ineligible to ESAs. Detectable MRD before HSCT is associated with worse survival in patients with MDS/MPN compared with undetectable MRD. Overall survival, nonrelapse mortality, and relapse rates were also assessed in the phase 2 trial which had these results. The new indication is for use of the alkylating agent with fludarabine in a preparatory combination for allogeneic HSCT. Juan Jose Rodriguez-Sevilla, MD, PhD, summarizes current clinical knowledge about inflammation within MDS pathobiology. An MDS HSPC signature generated from the model presents possible targets for treatment in patients with low-risk disease. The study's results especially highlight potential aberrant gene regulation by ZMAT2 and SMARCD3. The study showed a mortality risk reduction benefit in certain mutations while for others larger studies are needed. Researchers noted that confirmation of this relationship in lower-risk disease would require a larger study. Researchers argue from their findings that the 2023 criteria more accurately present the performance of ivosidenib in MDS. The combination in a phase II trial produced high complete response rates in patients with newly diagnosed AML. Researchers also analyzed baseline stem cells for insight into patient response versus non-response to the combination. The combination was compared with decitabine monotherapy in a multicenter, open-label, RCT. A study evaluated azacitidine combined with ipilimumab or nivolumab and triplet of these agents in treatment-naive MDS.