精确的风险预测对于管理骨髓增生异常综合征非常关键，因为这些骨髓衰竭性疾病的临床结果非常异质化。在过去的十年中，骨髓增生异常综合征中的分子病变快速扩张的大量基因数据为了解疾病病理学提供了前所未有的洞察力。最近，分子预测模型，如分子国际预后评分系统（IPSS-M），利用基因数据的丰富水源来改进传统风险模型，例如修订版IPSS（IPSS-R），但同时增加了相当大的复杂性。在本综述中，我们重点介绍早期骨髓增生异常综合征预测模型、骨髓增生异常综合征基因组学方面的重大进展以及近期分子为基础的预测模型的出现。最后，我们讨论了在抵达分子前沿时管理骨髓增生异常综合征中的重要机会和挑战。版权所有©2022 Elsevier Ltd.

Accurate risk prognostication is central to the management of myelodysplastic syndromes, given the widely heterogeneous clinical outcomes of these bone marrow failure disorders. Over the past decade, the rapidly expanding compendium of molecular lesions in myelodysplastic syndrome (MDS) has offered unprecedented insight into MDS pathobiology. Recently, molecular prognostic models such as the Molecular International Prognostic Scoring System (IPSS-M) have leveraged the wellspring of genetic data to improve upon traditional risk models such as the Revised IPSS (IPSS-R), but also added substantial complexity. In this review, we highlight early MDS prognostic models, the significant advancements in MDS genomics since then, and the recent advent of molecular based prognostic models. We conclude by discussing important opportunities and challenges in the management of MDS as we arrive at the molecular frontier.Copyright © 2022. Published by Elsevier Ltd.