Therapy-related MDS dissected based on primary disease and treatment—a nationwide perspective

Abstract

In this population-based study, we aimed to characterize and compare subgroups of therapy-related Myelodysplastic syndromes (t-MDS) and define the implications of type of previous treatment and primary disease. We combined data from MDS patients, diagnosed between 2009 and 2017 (n = 2705), in the nationwide Swedish MDS register, with several health registers. Furthermore, using matched population controls, we investigated the prevalence of antecedent malignancies in MDS patients in comparison with the general population. This first ever nationwide study on t-MDS confirms a shorter median survival for t-MDS compared to de novo MDS (15.8 months vs 31.1 months, p < 0.001). T-MDS patients previously treated with radiation only had disease characteristics with a striking resemblance to de novo-MDS, in sharp contrast to patients treated with chemotherapy who had a significantly higher risk profile. IPSS-R and the WHO classification differentiated t-MDS into different risk groups. As compared with controls, MDS patients had a six-fold increased prevalence of a previous hematological malignancy but only a 34% increased prevalence of a previous solid tumor. T-MDS patients with a previous hematological malignancy had a dismal prognosis, due both to mortality related to their primary disease and to high-risk MDS.

Latest Insights and Therapeutic Advances in Myelodysplastic Neoplasms

“…Conversely, the updated Fifth World Health Organization Classification of Myeloid Neoplasms (WHO-5) [1] continues to distinguish them as a specific disease entity. However, it is essential to recognize that secondary diseases carry a worse outcome, being frequently associated with poor prognosis TP53 mutations and complex karyotypes, as well as a shorter median survival compared to current treatment strategies [23,27,28].…”

Manganese-derived biomaterials for tumor diagnosis and therapy

“…However, the inherent tumor heterogeneity and complex tumor microenvironment (TME) often hinder the effectiveness of chemotherapeutic drugs and promote metastasis. Moreover, these commonly used treatment modalities are associated with diverse adverse effects, such as tissue damage, and clinical symptoms such as fever, nausea, respiratory distress syndrome, and vomiting disorders [ 24 ]. Emerging strategies such as chemodynamic therapy (CDT), photodynamic therapy (PDT), and immunotherapy have attracted considerable attention in biomedical research [ 25 ].…”