摘要
Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorderscharacterized by ineffective hematopoiesis; they manifest clinically as anemia, neutropenia, and thrombocytopenia.1'2 Higher risk MDS include patients in the intermediate-2 and high-risk categories of the International Prognostic Scoring System (IPSS), as well as patients with MDS secondary to radiation or chemical exposure.3 The patients with higher risk MDS have a peculiar propensity to evolve into acute myeloid leukemia (AML), and have a median survival of 〈12 months.4 Management of higher risk MDS varies from supportive care with transfusions or hematopoietic cytokines to high-intensity3 chemotherapy or hematopoietic stem cell transplantation. The impact of intensive myelosuppressive chemotherapy, similar to AML induction therapy, has been investigated. The results are comparable to the reported outcome of patients with AML, i.e. complete remission (CR) rates of 40%-60% and median overall survival (OS) of 8-12 months,s Thus, innovative approaches are needed for the treatment of higher risk MDS.
Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorderscharacterized by ineffective hematopoiesis; they manifest clinically as anemia, neutropenia, and thrombocytopenia.1'2 Higher risk MDS include patients in the intermediate-2 and high-risk categories of the International Prognostic Scoring System (IPSS), as well as patients with MDS secondary to radiation or chemical exposure.3 The patients with higher risk MDS have a peculiar propensity to evolve into acute myeloid leukemia (AML), and have a median survival of 〈12 months.4 Management of higher risk MDS varies from supportive care with transfusions or hematopoietic cytokines to high-intensity3 chemotherapy or hematopoietic stem cell transplantation. The impact of intensive myelosuppressive chemotherapy, similar to AML induction therapy, has been investigated. The results are comparable to the reported outcome of patients with AML, i.e. complete remission (CR) rates of 40%-60% and median overall survival (OS) of 8-12 months,s Thus, innovative approaches are needed for the treatment of higher risk MDS.