Re-defining Prognosis of Hematological Malignancies by Dynamic Response Assessment Methods: Lessons Learnt in Chronic Myeloid Leukemia, Hodgkin Lymphoma, Diffuse Large B Cell Lymphoma and Multiple Myeloma.

Risk-stratification is an essential management tool in defining prognosis of haematological neoplasms, both from patient and physician perspective. We define a new prognostic term "Dynamic Response Assessment Method(s) (DRAM)" as "method(s) used for re-stratifying disease prognosis at fixed intervals during the treatment course". The risk stratification is done after a fixed duration of treatment or chemotherapy cycles using sensitive techniques. The information obtained then can be used for further therapeutic decisions and prognostication. Currently, there is enough evidence that response to treatment improves the prognostic value of baseline disease variables in the management of Chronic Myeloid Leukemia, Hodgkin lymphoma, Diffuse Large B cell Lymphoma, and Multiple Myeloma. Through this review, we discuss the current evidence based application of "DRAM" to guide therapeutic decisions in these malignancies. We also discuss how the results of "DRAM" can be incorporated for redefining prognosis and counselling the patients with these selected hematologic malignancies.