Myelodysplastic syndromes: biology and treatment.
Optimal management of patients with myelodysplastic syndromes (MDS) requires an insight into the biology of the disease and the mechanisms of action of the available therapies. This review focuses on low-risk MDS, for which chronic anaemia and eventual progression to acute myeloid leukaemia are the main concerns. We cover the updated World Health Organization classification, the latest prognostic scoring system, and describe novel findings in the pathogenesis of 5q- syndrome. We perform in depth analyses of two of the most widely used treatments, erythropoietin and lenalidomide, discussing mechanisms of action, reasons for treatment failure and influence on survival.
Jädersten
M
M
Division of Hematology and Center of Experimental Hematology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. martin.jadersten@ki.se
Hellström-Lindberg
E
E
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D002895:Chromosomes, Human, Pair 5 / Q000235:genetics; D018450:Disease Progression; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007502:Iron Chelating Agents / Q000627:therapeutic use; D000077269:Lenalidomide; D008297:Male; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000235:genetics* / Q000628:therapy*; D011994:Recombinant Proteins; D017384:Sequence Deletion; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D014944:World Health Organization
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D007502:Iron Chelating Agents; D011994:Recombinant Proteins; D004921:Erythropoietin; D013792:Thalidomide; D000077269:Lenalidomide