Myelodysplastic syndrome.
During the past 15 years, important progress has been made in the understanding of the biology and prognosis of myelodysplastic syndrome (MDS). MDS is a clonal disorder characterized by ineffective hematopoiesis, which can lead to either fatal cytopenias or acute myelogenous leukemia (AML). Risk-adapted treatment strategies were established because of the high median age (60-75 years) of the MDS patients and the individual history of the disease (number of cytopenias, cytogenetic changes, transfusion requirements). Allogeneic bone marrow transplantation currently offers the only potentially curative treatment, but this form of therapy is not available for the typical MDS patient, who is >60 years of age. Therapy with erythropoietin and G-CSF has improved the quality of life of selected patients. The development of small molecules directed against specific molecular targets with minimal adverse effects is the hope for the future. Innovative uses of immunomodulatory agents and the optimizing of cytotoxic treatment should continue to help in the treatment of MDS.
Hofmann
Wolf-K
WK
Department of Hematology and Oncology and Transfusion Medicine, University Hospital Benjamin Franklin, 12200 Berlin, Germany. W.K.Hofmann@charite.de
Koeffler
H Phillip
HP
D000368:Aged; D016026:Bone Marrow Transplantation; D002423:Cause of Death; D004921:Erythropoietin / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D010198:Pancytopenia / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate
D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor