| Treatment options in advanced myelodysplastic syndrome, with emphasis on epigenetic therapy. | |
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MedLine Citation:
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PMID: 18055336 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Medical management of myelodysplastic syndrome (MDS) remains challenging, particularly in advanced stages where the risk of developing acute leukemia is very high and the prospect of survival is generally poor. Over the past decade, epigenetic changes such as alterations in DNA methylation and histone modifications have been well described in MDS and are now recognized as targets of therapy (epigenetic therapy). The aim of epigenetic therapy is to reverse epigenetic changes and reactivate important genes, thereby modifying the malignant phenotype and inducing the clearance of the malignant clone via various mechanisms. Epigenetic-modifying agents may also have mechanisms of anticancer action unrelated to gene reactivation. The hypomethylating agents azacitidine and decitabine induce clinically meaningful remissions or improvements in 30% to 60% of patients with this disease, and both agents have been approved in the United States for the treatment of advanced and/or symptomatic MDS. Histone deacetylase inhibitors belong to another class of epigenetic-modifying agents that also have clinical activity in MDS. They are currently being combined with hypomethylating agents. Among other available therapeutic options, allogeneic stem cell transplantation is the only curative approach for MDS but is also characterized by significant morbidities and mortality. We review epigenetic therapy and other therapeutic approaches for patients with advanced MDS. |
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Authors:
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Yasuhiro Oki; Jean-Pierre J Issa |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: International journal of hematology Volume: 86 ISSN: 0925-5710 ISO Abbreviation: Int. J. Hematol. Publication Date: 2007 Nov |
Date Detail:
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Created Date: 2007-12-06 Completed Date: 2008-03-11 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 9111627 Medline TA: Int J Hematol Country: United States |
Other Details:
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Languages: eng Pagination: 306-14 Citation Subset: IM |
Affiliation:
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Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals DNA Modification Methylases / antagonists & inhibitors, metabolism Disease Progression Epigenesis, Genetic / genetics* Histone Deacetylase Inhibitors Histone Deacetylases / metabolism Humans Myelodysplastic Syndromes / enzymology, pathology*, surgery, therapy* Stem Cell Transplantation |
| Chemical | |
Reg. No./Substance:
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0/Histone Deacetylase Inhibitors; EC 2.1.1.-/DNA Modification Methylases; EC 3.5.1.98/Histone Deacetylases |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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