Treatment options in myelodysplastic syndromes: a new frontier.
Myelodysplastic syndromes (MDS) are very heterogeneous diseases in terms of clinical presentation and prognosis. Patients with pure red cell dysplasias have a life expectancy of more than 10 years, whereas those with refractory anemias with excess blasts have survival shorter than 6 months. Until a few years ago, therapeutic options were palliative and supportive care only. Quite recently, the treatment panorama for MDS has radically changed and the different biological behavior of MDS requires a precise choice among completely different therapies: immunosuppressive agents, anti-apoptotic agents and growth factors are effective in low risk MDS, whereas epigenetic drugs, tyrosine kinase inhibitors, and possibly high dose chemotherapy and bone marrow transplantation are valuable in high risk MDS. We review the results of such therapies and the selection criteria for MDS patients.
Santini
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Hematology Unit, AOU Careggi, University of Florence, Italy. santini@unifi.it
Gozzini
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Bosi
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D004791:Enzyme Inhibitors / Q000627:therapeutic use; D056572:Histone Deacetylase Inhibitors; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000628:therapy; D018579:Patient Selection; D033581:Stem Cell Transplantation
D004791:Enzyme Inhibitors; D056572:Histone Deacetylase Inhibitors; D007166:Immunosuppressive Agents; D036341:Intercellular Signaling Peptides and Proteins