Document Detail


Myelodysplasia: the good, the fair and the ugly.
MedLine Citation:
PMID:  17336254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic disorders. The molecular pathogenesis of the disease is poorly understood and a large number of fundamental biologic questions remain. This heterogeneity presents challenges in selecting therapy for individual patients as well as for evaluating response to treatment. Only a small number of randomized clinical trials have been conducted, although three new drugs (azacitidine, lenalidomide, and decitabine) have been approved for use in the last few years. Response to most therapies occurs slowly, and sometimes months elapse before response can be evaluated. The response rates for most drugs used or studied for MDS range from <10%-20%. Some therapies seem more promising than others: immunosuppression with antithymocyte globulin results in extended durations of benefit in responders; lenalidomide induces a very high erythroid response rate in patients with del 5q- karyotype. The DNA hypomethylating agents, azacitidine and decitabine, can be of significant benefit for a fraction of patients and further investigation is needed to determine whether higher response rates occur in particular subgroups of MDS patients. Further refinements of dose and schedule of administration are also under investigation.
Authors:
Charles A Schiffer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Best practice & research. Clinical haematology     Volume:  20     ISSN:  1521-6926     ISO Abbreviation:  Best Pract Res Clin Haematol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-05     Completed Date:  2007-05-10     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  101120659     Medline TA:  Best Pract Res Clin Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  49-55     Citation Subset:  IM    
Affiliation:
Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R. Street, 4HW-CRC, Detroit, MI 48201, USA. schiffer@karmanos.org
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MeSH Terms
Descriptor/Qualifier:
Antilymphocyte Serum / therapeutic use*
Antineoplastic Agents / therapeutic use*
Azacitidine / analogs & derivatives,  therapeutic use
Bone Marrow Transplantation
Clinical Trials as Topic
Hematopoietic Stem Cell Transplantation
Humans
Immunosuppression / methods
Myelodysplastic Syndromes / drug therapy*,  genetics,  physiopathology
Thalidomide / analogs & derivatives,  therapeutic use
Chemical
Reg. No./Substance:
0/Antilymphocyte Serum; 0/Antineoplastic Agents; 191732-72-6/lenalidomide; 320-67-2/Azacitidine; 50-35-1/Thalidomide; 776B62CQ27/decitabine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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