title: Molecular and Cellular Mechanisms of Myelodysplastic Syndrome: Implications on Targeted Therapy.
abstract: Myelodysplastic syndrome (MDS) is a group of heterogeneous clonal hematopoietic stem cell disorders characterized by cytopenia, ineffective hematopoiesis, and progression to secondary acute myeloid leukemia in high-risk cases. Conventional prognostication relies on clinicopathological parameters supplemented by cytogenetic information. However, recent studies have shown that genetic aberrations also have critical impacts on treatment outcome. Moreover, these genetic alterations may themselves be a target for treatment. The mutation landscape in MDS is shaped by gene aberrations involved in DNA methylation (TET2, DNMT3A, IDH1/2), histone modification (ASXL1, EZH2), the RNA splicing machinery (SF3B1, SRSF2, ZRSR2, U2AF1/2), transcription (RUNX1, TP53, BCOR, PHF6, NCOR, CEBPA, GATA2), tyrosine kinase receptor signaling (JAK2, MPL, FLT3, GNAS, KIT), RAS pathways (KRAS, NRAS, CBL, NF1, PTPN11), DNA repair (ATM, BRCC3, DLRE1C, FANCL), and cohesion complexes (STAG2, CTCF, SMC1A, RAD21). A detailed understanding of the pathogenetic mechanisms leading to transformation is critical for designing single-agent or combinatorial approaches in target therapy of MDS.
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China. gillhsh@hku.hk.
authors.forename: Harinder
authors.initials: H
authors.lastname: Gill
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China. ayhleung@hku.hk.
authors.forename: Anskar Y H
authors.initials: AY
authors.lastname: Leung
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China. ylkwong@hkucc.hku.hk.
authors.forename: Yok-Lam
authors.initials: YL
authors.lastname: Kwong
mesh_terms: D019175:DNA Methylation / Q000235:genetics; D004260:DNA Repair / Q000235:genetics; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D012326:RNA Splicing / Q000235:genetics; D015398:Signal Transduction / Q000235:genetics; D014158:Transcription, Genetic / Q000235:genetics
keywords: gene mutations; myelodysplastic syndrome; prognostication; target therapy