No benefit of hypomethylating agents compared to supportive care for higher risk myelodysplastic syndrome.

This study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System. Methods: A total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed. Results: HMA therapy was administered to 205 patients (73.5%), including 31 patients (11.1%) who then received allogeneic hematopoietic cell transplantation (allo-HCT), while 74 patients (26.5%) received BSC or allo-HCT without HMA. The 3-year overall survival (OS) rates were 53.1% ± 10.7% for allo-HCT with HMA, 75% ± 21.7% for allo-HCT without HMA, 17.3% ± 3.6% for HMA, and 20.8% ± 6.9% for BSC groups (p
Source: The Korean Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Korean J Intern Med Source Type: research

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Allogeneic hematopoietic cell transplantation (HCT) is an established curative therapy for patients with high risk acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The success of allogeneic HCT is highly dependent on multiple patient, disease and transplant related factors [1-3]. Historically, allogeneic HCT was based on high intensity preparative regimens with an intent to achieve marrow aplasia. As the role of graft versus leukemia benefit became more evident in curing myeloid malignancies, several reduced intensity conditioning (RIC) regimens were studied and showed sustained engraftment, low regimen...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Myeloid malignancies such as acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS), are potentially life-threatening diseases of the elderly, occurring mostly in the seventh to eighth decades of life 1,2. The general approach to treatment is a form of induction chemotherapy followed by consideration of allogeneic hematopoietic cell transplant (allo-HCT) as consolidation therapy in select patients felt to have high-risk disease and be fit for transplantation. Historically, allo-HCT was reserved for young patients with an acceptable performance status but with the adaptation of reduced intensity and non-myeloab...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
A diagnosis of myelodysplastic syndrome (MDS), i.e. a cancerous disease with a variable risk of evolution into acute myeloid leukaemia [1] can trigger different emotions, particularly, psychological distress [2], as MDS can potentially be a life-threatening disease without any curative treatment except stem-cell transplant, which is not applicable for most patients [3]. Among lower-risk patients watchful waiting or symptomatic treatment might also generate distress because of the lack of MDS-focused treatment.
Source: Leukemia Research - Category: Hematology Authors: Source Type: research
AbstractAzacitidine and decitabine, two hypomethylating agents, are known to be effective in the treatment of high-risk myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) patients who cannot endure intensive cytotoxic chemotherapy or are not eligible for transplantation. However, the treatment response rate is low. The molecular mechanisms underlying the resistance to demethylation therapy are unclear. Though a wide range of predictors of treatment response have been investigated, no consensus has been reached. It is imperative to identify certain parameters that can help distinguish between patients who will...
Source: Annals of Hematology - Category: Hematology Source Type: research
CONCLUSIONS: We found no evidence for a difference between participants receiving ATRA in addition to chemotherapy or chemotherapy only for the outcome OS. Regarding DFS, CRR and on-study mortality, there is probably no evidence for a difference between treatment groups. Currently, it seems the risk of adverse events are comparable to chemotherapy only.As quality of life has not been evaluated in any of the included trials, further research is needed to clarify the effect of ATRA on quality of life. PMID: 30080246 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
z M, Alousi A, Couriel D, Pidala J, Arora M, Cutler C Abstract Upper gastrointestinal acute graft-versus-host disease is reported in approximately 30% of hematopoietic stem cell transplant recipients developing acute graft-versus-host disease. Currently classified as Grade II in Consensus criteria, upper gastrointestinal acute graft-versus-host disease is often treated with systemic immunosuppression. We reviewed the Center for International Blood and Marrow Transplant Research database to assess prognostic implications of upper gastrointestinal acute graft-versus-host disease in isolation or with other acute graf...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
Conditions:   Acute Lymphoblastic Leukemia in Remission;   Acute Myeloid Leukemia Arising From Previous Myelodysplastic Syndrome;   Acute Myeloid Leukemia in Remission;   Blasts 5 Percent or Less of Bone Marrow Nucleated Cells;   Chronic Myelomonocytic Leukemia;   Chronic Phase Chronic Myelogen ous Leukemia, BCR-ABL1 Positive;   Donor;   Minimal Residual Disease;   Myelodysplastic Syndrome;   Myelofibrosis;   Myeloproliferative Neoplasm;   Recurrent Acute Myeloid Leukemia;   ...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) developing in persons exposed to DNA-damaging agents for a prior cancer are often referred to as treatment- or therapy-related myeloid neoplasms (t-MN)[1,2]. t-MN constitute approximately 10-20% of all cases of AML and MDS[3], a proportion that may increase in the future with an increasing prevalence of cancer survivors[4,5]. Hematopoietic cell transplants (HCT) use high doses of drugs and/or ionizing radiations and can also lead to t-MN[6,7].
Source: Leukemia Research - Category: Hematology Authors: Source Type: research
Publication date: Available online 9 November 2017Source: Seminars in Cancer BiologyAuthor(s): Christian Flotho, Sebastian Sommer, Michael LübbertAbstractMyelodysplastic syndrome (MDS) is a clonal bone marrow disorder, typically of older adults, which is characterized by ineffective hematopoiesis, peripheral blood cytopenias and risk of progression to acute myeloid leukemia. Juvenile myelomonocytic leukemia (JMML) is an aggressive myeloproliferative neoplasm occurring in young children. The common denominator of these malignant myeloid disorders is the limited benefit of conventional chemotherapy and a particular resp...
Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
Publication date: July 2018Source: Journal of Geriatric Oncology, Volume 9, Issue 4Author(s): Marlise R. Luskin, Gregory A. AbelAbstractThe 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 70 years. Consequently, patients with MDS frequently have concurrent comorbidities and/or frailty which may be coincident ...
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research
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