Review of therapeutic options and the management of patients with myelodysplastic syndromes

Abstract

Myelodysplastic syndromes (MDS) are a poorly understood group of disorders caused by one or more genetic aberrations in the bone marrow-derived cell line responsible for hematopoiesis. Recent advances in genetic medicine have offered new insights into the epigenesis as well as the prognosis of MDS, but have not resulted in new or improved curative treatment options. Bone marrow transplantation, introduced before the advent of genetic medicine, is still the only potential cure. Advances in other medical and pharmaceutical areas have broadened the scope of supportive care and disease-modifying therapies, and treating physicians now have a broad range of disease management options depending on a patient’s likely prognosis. There is now clear evidence that appropriate supportive care and therapeutic intervention can improve progression-free and overall survival of MDS patients.

Keywords::

• chelation
• cytogenetic aberrations
• hematopoietic stem cell transplantation
• immunomodulating therapy
• immunosuppressive therapy
• International Prognostic Scoring System
• International Working Group for Prognosis in MDS
• iron overload
• myelodysplastic syndromes
• transfusion therapy

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

The authors received writing assistance from M Marais (Mudskipper, Hong Kong), for which Novartis Pharmaceuticals provided financial support. The authors were fully responsible for the content and editorial decisions for this manuscript.