Myelodysplastic Syndromes—Many New Drugs, Little Therapeutic Progress

Tefferi, Ayalew

doi:10.4065/mcp.2010.0502

Cited by 15 publications

(12 citation statements)

References 47 publications

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“…However, the position against chelation [35,36,37] is not warranted. It is now well established that adequately designed observational studies, though perhaps unable to provide causal evidence, provide accurate estimates of treatment effects [38,39] These extant consensus and individual recommendations are helpful in reconciling some of the reasons physicians in our study cited for not chelating patients, including age, life expectancy, and comorbidities (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Iron status and treatment modalities in transfusion-dependent patients with myelodysplastic syndromes

et al. 2011

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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 3 ABSTRACT Transfusion-dependency and iron overload are common among patients with myelodysplastic syndromes (MDS) treated with red blood cell (RBC) transfusions.Transfusion-dependency is associated with leukemic progression and shorter survival.Guidelines recommend iron chelation therapy to manage iron overload, however little is known about the chelation patterns in daily clinical practice. The objective of this multicenter, retrospective, cross-sectional, observational study was to evaluate iron status and its management in transfusion-dependent MDS patients. A total of 193 patient records from 29 centers were eligible for inclusion. Median patient age was 76 and median age at diagnosis of MDS was 74. Patients had received an average of 13.4+7.6 RBC units in the past four months; 44% had received more than 50 units since their MDS diagnosis. Medium serum ferritin was 1550g/L. Ninety patients (46.6%) received iron chelation therapy with either deferoxamine (41%), deferasirox (36%), and deferoxamine followed by deferasirox (23%). There were no statistically significant differences between chelated and nonchelated patients in terms of IPSS, FAB, and/or WHO status, though chelated patients had received more RBC transfusions (p=0.014).Iron chelation therapy may be underutilized in transfusion-dependent patients.

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Section: Discussionmentioning

confidence: 99%

Iron status and treatment modalities in transfusion-dependent patients with myelodysplastic syndromes

et al. 2011

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“…The limited efficacy of current therapies in MDS reflects our inadequate insight into disease pathogenesis (106). The wide variability in the contribution of pathogenic traits to different subtypes of MDS is reflected in the wide variability of responses to different therapeutic strategies.…”

Section: Therapeutic Targeting Of the Bm Microenvironment In Mdsmentioning

confidence: 99%

Evaluation of bone marrow microenvironment could change how myelodysplastic syndromes are diagnosed and treated

Aanei

Catafal

2018

Cytometry Pt A

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Myelodysplastic syndromes are a heterogeneous group of clonal hematopoietic disorders. However, the therapies used against the hematopoietic stem cells clones have limited efficacy; they slow the evolution toward acute myeloid leukemia rather than stop clonal evolution and eradicate the disease. The progress made in recent years regarding the role of the bone marrow microenvironment in disease evolution may contribute to progress in this area. This review presents the recent updates on the role of the bone marrow microenvironment in myelodysplastic syndromes pathogenesis and tries to find answers regarding how this information could improve myelodysplastic syndromes diagnosis and therapy.

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“…Lifelong transfusions can lead to secondary iron overload which shortens survival. However, due to low survival rate the risk and benefit of iron chelation therapy is not clear, and should be individualized (Barzi et al, 2010;Bryan et al, 2010;Tefferi 2010 DOI:http://dx.doi.org/10.7314/APJCP.2012.13.4…”

Section: Overview Of Managementmentioning

confidence: 99%