title: Diagnosis and treatment of primary myelodysplastic syndromes in adults: recommendations from the European LeukemiaNet.
abstract: Within the myelodysplastic syndrome (MDS) work package of the European LeukemiaNet, an Expert Panel was selected according to the framework elements of the National Institutes of Health Consensus Development Program. A systematic review of the literature was performed that included indexed original papers, indexed reviews and educational papers, and abstracts of conference proceedings. Guidelines were developed on the basis of a list of patient- and therapy-oriented questions, and recommendations were formulated and ranked according to the supporting level of evidence. MDSs should be classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires the evaluation of not only disease-related factors but also of those related to extrahematologic comorbidity. The assessment of individual risk enables the identification of fit patients with a poor prognosis who are candidates for up-front intensive treatments, primarily allogeneic stem cell transplantation. A high proportion of MDS patients are not eligible for potentially curative treatment because of advanced age and/or clinically relevant comorbidities and poor performance status. In these patients, the therapeutic intervention is aimed at preventing cytopenia-related morbidity and preserving quality of life. A number of new agents are being developed for which the available evidence is not sufficient to recommend routine use. The inclusion of patients into prospective clinical trials is strongly recommended.
authors: Department of Hematology and Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, and.
authors: Luca
authors: L
authors: Malcovati
authors: Eva
authors: E
authors: Hellström-Lindberg
authors: David
authors: D
authors: Bowen
authors: Lionel
authors: L
authors: Adès
authors: Jaroslav
authors: J
authors: Cermak
authors: Consuelo
authors: C
authors: Del Cañizo
authors: Matteo G
authors: MG
authors: Della Porta
authors: Pierre
authors: P
authors: Fenaux
authors: Norbert
authors: N
authors: Gattermann
authors: Ulrich
authors: U
authors: Germing
authors: Joop H
authors: JH
authors: Jansen
authors: Moshe
authors: M
authors: Mittelman
authors: Ghulam
authors: G
authors: Mufti
authors: Uwe
authors: U
authors: Platzbecker
authors: Guillermo F
authors: GF
authors: Sanz
authors: Dominik
authors: D
authors: Selleslag
authors: Mette
authors: M
authors: Skov-Holm
authors: Reinhard
authors: R
authors: Stauder
authors: Argiris
authors: A
authors: Symeonidis
authors: Arjan A
authors: AA
authors: van de Loosdrecht
authors: Theo
authors: T
authors: de Witte
authors: Mario
authors: M
authors: Cazzola
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015897:Comorbidity; D005060:Europe; D019317:Evidence-Based Medicine; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous
chemical_list: D000970:Antineoplastic Agents
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