1,721,004 research outputs found
[Prognosis and Therapy of Myelodysplastic Syndrome].
No full textPrognosis and Therapy of Myelodysplastic Syndrome Abstract. The myelodysplastic syndromes (MDS) represent a heterogeneous group of diseases affecting the hematopoietic stem cells, which are characterized by reduced blood cells (cytopenia), maturation disorders (dysplasia) and an increased risk of transformation into acute myeloid leukemia (AML). For adequate treatment, disease and patient-related factors must be taken into account and the therapies are very different for lower- and higher-risk diseases, respectively. In the case of lower-risk diseases, the focus is on improving cytopenias and quality of life, while in the case of higher-risk diseases the prolongation of survival with a delay of transformation to AML. Only a small proportion of higher-risk MDS patients qualify for the only potentially curative treatment of hematopoietic stem cell transplantation. This review article summarizes the most important aspects of prognosis and therapy in MDS patients for the practicing physician
Diagnostik und Therapie myelodysplastischer Syndrome
No full textDiagnosis and treatment of myelodysplastic syndromes
The myelodysplastic syndromes (MDS) are heterogeneous clonal disorders of
the hematopoietic stem cells and affect mainly elderly people from the 7th decade
of life. Management of MDS patients is challenging due to the broad spectrum
of presentations and courses of the disease, varying from chronic cytopenia
to rapid progression towards acute myeloid leukaemia (AML). The incidence
and prevalence of MDS is expected to increase due to ageing of the population.
Therefore, MDS is assumed to become one of the most important haematologic
malignancies with an emerging impact on future healthcare costs. The only curative
treatment is an allogeneic hematopoietic stem cell transplantation for
which only a minority of patients is eligible. This review shall provide an update
for practicing hemato-oncologists on the current understanding of pathophysiology
as well as the recommendations for diagnosis and treatment of this
emerging disease
Current status and trends in the diagnostics of AML and MDS.
No full textDiagnostics of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) have recently been experiencing extensive modifications regarding the incorporation of next-generation sequencing (NGS) strategies into established diagnostic algorithms, classification and risk stratification systems, and minimal residual disease (MRD) detection. Considering the increasing arsenal of targeted therapies (e.g. FLT3 or IDH1/IDH2 inhibitors) for AML, timely and comprehensive molecular mutation screening has arrived in daily practice. Next-generation flow strategies allow for immunophenotypic minimal residual disease (MRD) monitoring with very high sensitivity. At the same time, standard diagnostic tools such as cytomorphology or conventional cytogenetics remain cornerstones for the diagnostic workup of myeloid malignancies. Herein, we summarize the most recent advances and new trends for the diagnostics of AML and MDS, discuss the difficulties, which accompany the integration of these new methods and their results into daily routine, and aim to define the role hemato-oncologists may play in this new diagnostic era
Management of Adult Patients with Myelodysplastic Syndromes
Full text linkThe myelodysplastic syndromes (MDS) form a heterogeneous group of clonal disorders with an increasing incidence in the elderly population and an emerging impact on healthcare resources. MDS are caused by gene mutations affecting the haematopoietic stem cells, leading to ineffective haematopoiesis, characterised by dysplasia and cytopenia, and a propensity to evolve towards secondary acute myeloid leukaemia (AML). Accurate diagnosis and risk assessment are essential for the correct treatment allocation. In lower-risk MDS patients, median survival reaches 3–8 years and mortality is mainly caused by cytopenia (cardiovascular events, infections, and bleeding). Therefore, the treatment for these patients should be focussed on reduction of disease-related complications, disease progression, and improvement of quality of life. In contrast, in higher-risk MDS patients, median survival ranges from 1–3 years and death from transformation to AML exceeds non-leukaemic mortality. Treatment should be aimed to delay progression to AML and improve overall survival. Allogeneic haematopoietic stem cell transplant remains the only curative option for higher-risk MDS patients. However, only a minority of patients are eligible for such intensive treatment. Consequently, most patients are managed with supportive care and palliative treatment, including growth factors, immune-modulators, and hypomethylating agents. Since elderly patients with chronic cytopenia are frequently seen in general practice, awareness of the wide spectrum of presentations of MDS and potential courses of lower and higher-risk diseases are important for primary healthcare physicians
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