I’m Dr Pierre Fenaux from Hôpital St Louis in Paris and I’m also Chairman of the French Myelodysplastic Syndrome Group, MDS. I’m co-leader of the MDS part which is in Work Package 2 where the idea is, of course, by using great patient numbers and a great number of samples trying to define better a few questions. The first question we’re going to tackle is the prognostic factors of treatment with hypomethylating agents which are currently, I would say, the mainstay of treatment in high risk MDS. So we plan to collect greater than 3,000 samples, and probably now closer to 4,000, and trying to refine the prognostic factors of patients overall but also of some subgroups like, for instance, chronic myelomonocytic leukaemia, trying to define the prognosis of some cytogenetic groups, molecular groups, to analyse also the long survivors, those who have prolonged response, the initial complications like infection. So this big number of patients will allow us to respond to quite a few questions.

Many, many European groups are included and they have sequenced many of those patients so we plan probably to have about 1,500 patients with a complete sequence of most involved myeloid genes. Also other tests should be available in smaller numbers of patients, that’s a few hundreds like flow cytometry, like RNA-Seq and other data that will help us more precisely define the outcome of those patients which is currently not very well known.

Is this a good opportunity to work with a large number of patients?

Yes, it’s true. We’ve had the opportunity to work on two, three, perhaps four hundred patients but never as many and I think this will help us to answer many questions. I’ve got to say, for instance, the optimal number of cycles before transplant, when a patient can be transplanted, what drugs we should combine to hypomethylating agents because a few hundreds of patients have been treated with drugs in addition to hypomethylating agents. So it’s really the first opportunity we’ve had to work with such large cohorts of patients. That’s the first project but of course there could be many more projects in the field of MDS.

What will be gained by working with such large numbers of patients?

It will be to define the outcome specific subgroups as was done or is being done in acute myeloid leukaemia. So this allows you to determine the outcome of specific groups and therefore better tailor therapy and have more individualised therapy for each patient.