Myelodysplasia: when to treat and how

Best Practice & Research. Clinical Haematology
Richard A Larson

Abstract

Myelodysplastic syndrome (MDS) is a disorder of hematopoietic stem cells characterized by ineffective hematopoiesis. The result is pancytopenia leading to transfusion-dependent anemia, an increased risk of infection or bleeding, and a potential to progress to acute myeloid leukemia (AML). MDS is most prevalent among older individuals, many of whom also suffer from other medical conditions. MDS is classified according to World Health Organization criteria and the International Prognostic Scoring System. Supportive care remains the mainstay of therapy. Those with low-risk MDS can often be monitored for an extended period of time without specific therapy, whereas those with intermediate- or high-risk MDS benefit from treatment. Currently, only azacitidine is approved for the treatment of MDS. Several new agents are being tested, including inhibitors of angiogenesis (thalidomide, lenalidomide), farnesyl transferase inhibitors (lonafarnib, tipifarnib), and DNA methyltransferase inhibitors (azacitidine, decitabine). Lenalidomide appears particularly effective in patients with low-risk MDS with the deletion of chromosome 5q31. Allogeneic stem cell transplantation is an alternative for high-risk MDS. With advances in transplantation te...Continue Reading

References

May 16, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lewis R SilvermanJames F Holland
May 16, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Alice B KornblithJimmie C Holland
Oct 30, 2003·Aging Clinical and Experimental Research·Francesco LandiUNKNOWN SILVERNET-HC Study Group
Feb 11, 2005·The New England Journal of Medicine·Alan ListJerome B Zeldis

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Citations

May 15, 2013·Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale·Karin MurerMichael B Soyka
Dec 7, 2007·International Journal of Hematology·Yataro Yoshida
Mar 30, 2007·British Journal of Haematology·Ali-Reza GolshayanMikkael A Sekeres

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