Current therapeutic approaches for patients with myelodysplastic syndromes

被引：28

作者：

Greenberg, Peter L. ^{[1
]}

机构：

[1] Stanford Univ, Ctr Canc, Div Hematol, Stanford, CA 94305 USA

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2010年 / 150卷 / 02期

关键词：

myelodysplastic syndromes; treatment; classification; prognosis; iron chelation; ACUTE MYELOID-LEUKEMIA; COLONY-STIMULATING FACTOR; HEMATOPOIETIC-CELL TRANSPLANTATION; QUALITY-OF-LIFE; HIGH-RISK; DARBEPOETIN-ALPHA; ERYTHROID RESPONSE; PROGNOSTIC-FACTORS; REFRACTORY-ANEMIA; CLINICAL-OUTCOMES;

D O I：

10.1111/j.1365-2141.2010.08226.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

P>The myelodysplastic syndromes (MDS) are a heterogeneous spectrum of disorders requiring selective therapy based on patients' specific clinical features, predominantly their prognostic subgroups, age and performance status. Guidelines for management of patients with MDS have been generated by a number of national panels. This review focuses on evidence-based data supporting therapeutic approaches, which have also been recommended by the US National Comprehensive Cancer Network MDS Panel, with discussion of accessibility of recommended drugs in the US and in other countries. For lower risk disease (International Prognostic Scoring System Low and Intermediate-1) therapy is aimed at haematological improvement whereas for higher risk disease (Intermediate-2 and High) treatment focuses on altering disease natural history. Recent information regarding additional clinical and biological features has provided useful parameters for assessing disease prognosis that aid risk-based management decisions. The rationale for use of low versus high intensity therapies with these agents, including allogeneic haematopoietic stem cell transplantation, is discussed in detail.

引用

页码：131 / 143

页数：13

共 105 条

[31] Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study [J].

Fenaux, Pierre ;

Mufti, Ghulam J. ;

Hellstrom-Lindberg, Eva ;

Santini, Valeria ;

Finelli, Carlo ;

Giagounidis, Aristoteles ;

Schoch, Robert ;

Gattermann, Norbert ;

Sanz, Guillermo ;

List, Alan ;

Gore, Steven D. ;

Seymour, John F. ;

Bennett, John M. ;

Byrd, John ;

Backstrom, Jay ;

Zimmerman, Linda ;

McKenzie, David ;

Beach, C. L. ;

Silverman, Lewis R. .

LANCET ONCOLOGY, 2009, 10 (03) :223-232

[32] PKC412 inhibits in vitro growth of neoplastic human mast cells expressing the D816V-mutated variant of KIT:: comparison with AMN107, imatinib, and cladribine (2CdA) and evaluation of cooperative drug effects [J].

Gleixner, KV ;

Mayerhofer, M ;

Aichberger, KJ ;

Derdak, S ;

Sonneck, K ;

Böhm, A ;

Gruze, A ;

Samorapoompichit, P ;

Manley, PW ;

Fabbro, D ;

Pickl, WF ;

Sillaber, C ;

Valent, P .

BLOOD, 2006, 107 (02) :752-759

[33] Patients with del(5q) MDS who fail to achieve sustained erythroid or cytogenetic remission after treatment with lenalidomide have an increased risk for clonal evolution and AML progression [J].

Goehring, Gudrun ;

Giagounidis, Aristoteles ;

Buesche, Guntram ;

Kreipe, Hans Heinrich ;

Zimmermann, Martin ;

Hellstroem-Lindberg, Eva ;

Aul, Carlo ;

Schlegelberger, Brigitte .

ANNALS OF HEMATOLOGY, 2010, 89 (04) :365-374

[34]

Goss Thomas F, 2006, Cancer Control, V13 Suppl, P17

[35] Activity of the tyrosine kinase inhibitor PKC412 in a patient with mast cell leukemia with the D816V KIT mutation [J].

Gotlib, J ;

Berubé, C ;

Growney, JD ;

Chen, CC ;

George, TI ;

Williams, C ;

Kajiguchi, T ;

Ruan, J ;

Lilleberg, SL ;

Durocher, JA ;

Lichy, JH ;

Wang, YF ;

Cohen, PS ;

Arber, DA ;

Heinrich, MC ;

Neckers, L ;

Galli, SJ ;

Gilliland, DG ;

Coutré, SE .

BLOOD, 2005, 106 (08) :2865-2870

[36] A phase II intra-patient dose-escalation trial of weight-based darbepoetin alfa with or without granulocyte-colony stimulating factor in myelodysplastic syndromes [J].

Gotlib, Jason ;

Lavori, Philip ;

Quesada, Sylvia ;

Stein, Richard S. ;

Shahnia, Shahin ;

Greenberg, Peter L. .

AMERICAN JOURNAL OF HEMATOLOGY, 2009, 84 (01) :15-20

[37]

GREENBERG P, 1993, BLOOD, V82, pA196

[38] International scoring system for evaluating prognosis in myelodysplastic syndromes [J].

Greenberg, P ;

Cox, C ;

LeBeau, MM ;

Fenaux, P ;

Morel, P ;

Sanz, G ;

Sanz, M ;

Vallespi, T ;

Hamblin, T ;

Oscier, D ;

Ohyashiki, K ;

Toyama, K ;

Aul, C ;

Mufti, G ;

Bennett, J .

BLOOD, 1997, 89 (06) :2079-2088

[39]

Greenberg Peter L, 2009, J Natl Compr Canc Netw, V7 Suppl 9, pS1

[40]

Greenberg Peter L., 2006, P1

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