Journal ArticleDOI
The Myelodysplastic Syndromes: Diagnosis and Treatment
David P. Steensma,John M. Bennett +1 more
- Vol. 81, Iss: 1, pp 104-130
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TLDR
A contemporary, practical clinical approach to the diagnosis and risk-stratified treatment of MDS is presented and how to evaluate patients who may have a form of the condition is detailed.Abstract:
The myelodysplastic syndromes (MDSs) are common, acquired, clinically challenging hematologic conditions that are characterized by bone marrow failure and a risk of progression to acute leukemia. These disorders can arise de novo, especially in elderly patients or, less often, as a consequence of prior chemotherapy or radiotherapy for an unrelated disease. The MDS classification systems were revised recently and updated. These refined classification and prognostic schemes help stratify patients by their risk of leukemia progression and death; this knowledge can help clinicians select appropriate therapy. Although many treatments for MDS have been proposed and evaluated, at present, only hematopoietic stem cell transplantation offers any real hope for cure, and no available therapy beyond general supportive care offers benefit to more than a minority of patients. However, recent clinical trials enrolling patients with MDS have reported encouraging results with use of newer drugs, including lenalidomide, decitabine, and darbepoetin alfa. Other exciting treatment regimens are being tested. Here, we present a contemporary, practical clinical approach to the diagnosis and risk-stratified treatment of MDS. We review when to suspect MDS, detail how to evaluate patients who may have a form of the condition, explain key features of treatments that are currently available in the United States, and summarize a general, common-sense therapeutic approach to patients with MDS.read more
Citations
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Journal ArticleDOI
The genetics of myelodysplastic syndrome: from clonal haematopoiesis to secondary leukaemia.
TL;DR: The molecular processes that lead to CHIP and further clonal evolution to MDS and sAML are discussed, and the ways in which these insights are shaping the clinical management of MDS are highlighted, including classification schemata, prognostic scoring systems and therapeutic approaches.
Journal ArticleDOI
Definitions and standards in the diagnosis and treatment of the myelodysplastic syndromes: Consensus statements and report from a working conference
Peter Valent,Hans-Peter Horny,John M. Bennett,Christa Fonatsch,Ulrich Germing,Peter L. Greenberg,Torsten Haferlach,Detlef Haase,H. J. Kolb,Otto Krieger,Michael R. Loken,Arjan A. van de Loosdrecht,Kiyoyuki Ogata,Alberto Orfao,Michael Pfeilstöcker,Björn Rüter,Wolfgang R. Sperr,Reinhard Stauder,Denise A. Wells +18 more
TL;DR: Concerning the diagnostic interface, minimal diagnostic criteria for MDS are proposed, and for patients with unexplained cytopenia who do not fulfill these criteria, the term 'idiopathic cy topenia of uncertain significance' (ICUS) is suggested.
Journal ArticleDOI
Hematopoietic Engraftment and Survival in Adult Recipients of Umbilical-Cord Blood From Unrelated Donors
Mary J. Laughlin,Juliet N. Barker,Barbara Bambach,Omer N. Koc,David A. Rizzieri,John E. Wagner,Stanton L. Gerson,Hillard M. Lazarus,Mitchell S. Cairo,Cladd E. Stevens,Pablo Rubinstein,Joanne Kurtzberg +11 more
TL;DR: In this paper, transplantation of umbilical cord blood from unrelated donors who are not HLA-identical with the recipients can restore hematopoiesis after myeloablative therapy in children.
Book ChapterDOI
Epidemiology and Etiology
TL;DR: Probable causes of hematopoietic cancers, supported by multiple epidemiologic studies as well as similar findings for AML, are smoking, obesity, solvents and pesticides (without knowledge of specific exposures).
Journal ArticleDOI
Prevalence, incidence and types of mild anemia in the elderly: the "Health and Anemia" population-based study.
Mauro Tettamanti,Ugo Lucca,Francesca Gandini,Angela Recchia,Paola Mosconi,Giovanni Apolone,Alessandro Nobili,Maria Vittoria Tallone,Paolo Detoma,Adriano Giacomin,Mario Clerico,Patrizia Tempia,Luigi Savoia,Gilberto Fasolo,Luisa Ponchio,Matteo G. Della Porta,Emma Riva +16 more
TL;DR: The prevalence and incidence of mild anemia increase with age and Mild anemia affects more than one out of ten elderly individuals, which is common and may be due to myelodysplastic syndromes in some cases.
References
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Journal ArticleDOI
International Scoring System for Evaluating Prognosis in Myelodysplastic Syndromes
Peter L. Greenberg,Christopher Cox,Michelle M. LeBeau,Pierre Fenaux,Pierre Morel,Guillermo Sanz,Miguel A. Sanz,Teresa Vallespi,Terry J. Hamblin,David Oscier,Kazuma Ohyashiki,Keisuke Toyama,Carlo Aul,Ghulam J. Mufti,John M. Bennett +14 more
TL;DR: The International MDS Risk Analysis Workshop combined cytogenetic, morphological, and clinical data from seven large previously reported risk-based studies that had generated prognostic systems as discussed by the authors.
Journal ArticleDOI
Proposals for the classification of the myelodysplastic syndromes.
John M. Bennett,Daniel Catovsky,Marie-Thérèse Daniel,G. Flandrin,David A. G. Galton,Harvey R. Gralnick,Harvey R. Gralnick,C. Sultan +7 more
TL;DR: It is now proposed that over 30% of bone marrow blasts will suffice for the diagnosis of acute myeloid leukaemia (AML) in any of its forms (M1‐M6) and recognition of the new category, RAEB in transformation, may throw light on the pathogenesis of AML.
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TL;DR: The experience of developing the WHO Classification has produced a new and exciting degree of cooperation and communication between oncologists and pathologists from around the world, which should facilitate progress in the understanding and treatment of hematologic malignancies.
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