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Myeloablative Versus Reduced-Intensity Hematopoietic Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndromes

This research article has led to a Practice Changing Update on DynaMed Plus. It found that myeloablative conditioning increases relapse-free survival, but also increases treatment-related mortality compared to reduced intensity conditioning in patients with acute myeloid leukemia or myelodysplastic syndromes having first allogeneic hematopoietic cell transplantation
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

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Abstract Partial tandem duplication (PTD) of the KMT2A (MLL) gene is a poor prognostic factor in acute myeloid leukemia, but its significance in the context of myelodysplastic syndrome (MDS) is unknown. Here, we used cytogenomic array to identify MLL-PTD in a group of MDS patients and compared their clinicopathologic characteristics with a cohort of high-risk MDS patients without MLL-PTD. We show that MLL-PTD defines a subset of MDS characterized by high blast count, normal karyotype, and extremely poor prognosis exceeding that of non-MLL-PTD high risk MDS, including those with complex karyotype. Survival of MLL-P...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
AbstractIn contrast to the evidence regarding azacitidine (Aza), there is limited knowledge about the combination of decitabine (DAC) and donor lymphocyte infusions as salvage therapy for relapse after allogeneic stem cell transplantation (allo-SCT) so far. We retrospectively analyzed data of 36 patients with hematological (n = 35) or molecular relapse (n = 1) of acute myeloid leukemia (AML,n = 29) or myelodysplastic syndrome (MDS,n = 7) collected from 6 German transplant centers. Patients were treated with a median of 2 cycles DAC (range, 1 to 11). DAC was the first ...
Source: Annals of Hematology - Category: Hematology Source Type: research
Publication date: Available online 29 December 2017 Source:Journal of Geriatric Oncology Author(s): Marlise R. Luskin, Gregory A. Abel The myelodysplastic syndromes (MDS) are a varied group of hematologic neoplasms that lead to bone marrow failure, and also carry a risk of progression to acute myeloid leukemia. Patients with MDS suffer significant impairments to both their quality of life and survival. Age is the dominant risk factor for the development of MDS, with a median age at diagnosis over 70years. Consequently, patients with MDS frequently have concurrent comorbidities and/or frailty which may be coincident or rel...
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research
Allogeneic hematopoietic stem cell transplantation (HCT) remains the best established curative treatment for high-risk hematologic malignancies. Common indications for HCT, such as acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), are largely diseases of older age and have poor outcomes after nontransplant therapy [1,2]. The feasibility of HCT after reduced-intensity conditioning (RIC) from HLA-matched related (MRD) or unrelated donor (MUD) has been well established, permitting overall survival (OS) of around 30% to 50% [3,4].
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Haplo/cord transplantation combines an umbilical cord blood (UCB) graft with CD34-selected haploidentical cells and results in rapid hematopoietic recovery followed by durable UCB engraftment. We compared outcomes of transplants in older patients with acute myeloid leukemia (AML) or high-risk myelodysplastic syndromes (MDS) who received either HLA-matched unrelated donor cells (MUD) or haplo/cord grafts. Between 2007 and 2013, 109 adults ages 50 and older underwent similar reduced intensity conditioning (RIC) with fludarabine and melphalan and antibody-mediated T-cell depletion for AML (n=83) or high risk MDS (n=26) follow...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Minimizing toxicity while maximizing efficacy is a goal that has proven challenging in patients who are considered high risk for relapse after allogeneic hematopoietic cell transplantation (HCT), particularly in older individuals. The median patient age at diagnosis of myelodysplastic syndromes (MDS) is in the early 70s [1] and for acute myeloid leukemia (AML) in the mid-to-late 60s (SEER statistics, 2005 to 2009), and typically reduced-intensity conditioning regimens are used in preparation for HCT.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Relapse remains the main obstacle for patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) after allogeneic stem cell transplantation and novel therapeutic strategies are urg... Author: VJHemOnc Added: 12/18/2017
Source: Oncology Tube - Category: Cancer & Oncology Source Type: podcasts
The outcome for patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) after allogeneic stem cell transplantation remains poor. In this interview, Charles Craddock, CBE, FRCP (U... Author: VJHemOnc Added: 12/18/2017
Source: Oncology Tube - Category: Cancer & Oncology Source Type: podcasts
Conclusion Danazol as first-line therapy is an acceptable treatment option with low side effects for patients with MDS who cannot receive ASCT. Micro-Abstract At present, no standard therapy is available for most patients with myelodysplastic syndrome. In this retrospective study, we analyze data from 42 patients with myelodysplastic syndrome treated with low-dose danazol. More than half achieved a response. Results show that danazol remains an attractive option because of its low cost and good safety profile in centers with reduced access to novel therapeutic alternatives.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusion Danazol as frontline therapy is an acceptable treatment option with low side effects for patients with MDS that cannot receive ASCT Teaser At present, no standard therapy is available for most patients with myelodysplastic syndromes. In this retrospective study, we analyse data from 42 patients with myelodysplastic syndrome treated with low-dose danazol. More than half achieved a response. Results show that danazol remains an attractive option due to its low cost and good safety profile in centers with reduced access to novel therapeutic alternatives.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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