Low dose Ara-C for myelodysplastic syndromes: is it still a current therapy?

Leukemia & Lymphoma
Giuseppe VisaniAlessandro Isidori

Abstract

The myelodysplastic syndromes (MDS) are characterized by hemopoietic insufficiency associated with severe cytopenias, leading to serious morbidity, and acute leukemia development. MDS typically occur in elderly people, with a median age at diagnosis ranging between 60 and 75 years. The patients' prognosis, estimated according to the International Prognostic Scoring System, age and performance status should be considered before choosing among the various treatment options. A therapeutic dilemma exists in MDS, due to the multifactorial pathogenetic features of the disease, the heterogeneous stage and the elderly age of patients at diagnosis. This is underlined by the absence of a Food and Drug Administration-approved agent with an indication for this disease. The therapeutic end-points vary from symptom management (using low-intensity treatment with biological targeted agents, or only supportive therapy), to attempts to change the natural history of the disease (generally using high intensity treatment, including intensive chemotherapy and hemopoietic stem cell transplantation). The main goal of low-intensity therapies is generally to induce hematological improvements and is mainly used for low-risk disease. On the other hand, hi...Continue Reading

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Citations

Jan 12, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Guillermo Garcia-Manero, Pierre Fenaux
Dec 2, 2008·Best Practice & Research. Clinical Haematology·Richard M Stone

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