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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We report here indiscriminate killing of CD123+ normal and acute myeloid leukemia / myelodysplastic syndrome cells by SL-401, a diphtheria toxin interleukin-3 fusion protein. SL-401 induced cytotoxicity of CD123+ primary cells/blasts from acute myeloid leukemia and myelodysplastic syndrome patients but not CD123- lymphoid cells. Importantly, SL-401 was highly active even in cells expressing low levels of CD123, with minimal effect on modulation of the CD123 target in acute myeloid leukemia. SL-401 significantly prolonged survival of leukemic mice in acute myeloid leukemia patient-derived xenograft mouse models. In addition...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
In patients with myeloid malignancies, such as acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS), relapse remains the main cause of treatment failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) [1-4]. Several studies addressing therapeutic strategies for relapse after allo-HSCT have shown that treatment is more effective when initiated at molecular relapse rather than at hematologic relapse [5]. Therefore, early detection of imminent relapse, ideally at a molecular level, is a prerequisite for successful therapeutic intervention and can be achieved by regular monitoring of minimal...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
This multicenter study evaluated a treosulfan-based regimen in children and young adults with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplant (HCT). Forty patients with median age 11 years (1-19) underwent allogeneic HCT for AML in first (n=18), second (n=11), third or greater remission (n=3); or MDS (n=8) using bone marrow (n=25), peripheral blood stem cells (n=5) or cord blood (n=9). The regimen consisted of body surface area (BSA)-based treosulfan 10 g/m2/day (BSA ≤ 0.5 m2), 12 g/m2/day (BSA> 0.5 – 1.0 m2), or 14 g/m2/day (BSA> 1.0 m2) on ...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Hematologic malignancies are more prevalent in older patients, and because of the increased rate of elderly in the population, the number of patients presenting with hematologic malignancy has increased [1]. The median ages of patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS), which are the most common indication for allogeneic hematopoietic transplantation (alloHCT), in this population are 69 and 76 years, respectively [2-4]. Despite the advent of the novel agents, alloHCT remains the only curative option for most of the common hematologic malignancies.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
This multicenter study evaluated a treosulfan-based regimen in children and young adults with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplant (HCT). Forty patients with median age 11 years (range, 1 to 19) underwent allogeneic HCT for AML in first (n  = 18), second (n = 11), and third or greater remission (n = 3) or MDS (n = 8) using bone marrow (n = 25), peripheral blood stem cells (n = 5), or cord blood (n = 9). The regimen consisted of body surface area (BSA...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
AbstractPrimary graft failure can be a cause of early morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT), as it leads to a high risk of severe infections and bleeding. Splenomegaly is associated with primary graft failure in patients of myelofibrosis, but the association between splenomegaly and outcomes after HSCT in patients with myeloid malignancies has not been previously evaluated. The aim of this study was to investigate the effect of spleen volume on engraftment kinetics in patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). We enrolled 85 patients. The...
Source: Annals of Hematology - Category: Hematology Source Type: research
A 62-year-old man with acute myeloid leukemia, evolved from myelodysplastic syndrome after allogeneic bone marrow transplant, was admitted to the hospital because of worsening fatigue and altered level of consciousness. On arrival at the hospital, the patient was markedly fatigued and had signs of encephalopathy. He reported no fevers, chills, or diaphoresis but noted new urinary incontinence and nausea. His medical history was notable for a matched unrelated donor allogeneic hematopoietic stem cell transplant (HCT), performed 35 days previously, as well as hypertension and peripheral vascular disease.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' Clinic Source Type: research
Publication date: Available online 5 April 2018 Source:The Lancet Haematology Author(s): Martin Wermke, Julia Eckoldt, Katharina S Götze, Stefan A Klein, Gesine Bug, Liesbeth C de Wreede, Michael Kramer, Friedrich Stölzel, Malte von Bonin, Johannes Schetelig, Michael Laniado, Verena Plodeck, Wolf-Karsten Hofmann, Gerhard Ehninger, Martin Bornhäuser, Dominik Wolf, Igor Theurl, Uwe Platzbecker Background The effect of systemic iron overload on outcomes after allogeneic haemopoietic cell transplantation (HCT) has been a matter of substantial debate. We aimed to investigate the predictive value of both stored (...
Source: The Lancet Haematology - Category: Hematology Source Type: research
Pediatric myelodysplastic syndromes (MDSs) are a heterogeneous group of clonal disorders with an annual incidence of 1 to 4 cases per million, accounting for less than 5% of childhood hematologic malignancies. MDSs in children often occur in the context of inherited bone marrow failure syndromes, which represent a peculiarity of myelodysplasia diagnosed in pediatric patients. Moreover, germ line syndromes predisposing individuals to develop MDS or acute myeloid leukemia have recently been identified, such as those caused by mutations in GATA2, ETV6, SRP72, and SAMD9/SAMD9-L. Refractory cytopenia of childhood (RCC) is the m...
Source: Blood - Category: Hematology Authors: Tags: Pediatric Hematology, Transplantation, How I Treat, Free Research Articles, Myeloid Neoplasia Source Type: research
Contributors : Hiroyoshi Kunimoto ; Cem Meydan ; Francine E Garrett-Bakelman ; Caroline Sheridan ; Tak Lee ; Yaseswini Neelamraju ; Ari Melnick ; Ross L LevineSeries Type : Methylation profiling by high throughput sequencingOrganism : Mus musculusRecent studies using next-generation sequencing technology have uncovered mutational landscapes of various myeloid malignancies (Cancer Genome Atlas Research Network, 2013; Yoshida et al., 2011). These genetic data revealed novel classes of mutations that commonly occur in patients with myeloid malignancies, including epigenetic regulators and spliceosomal genes. In addition, co-o...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Methylation profiling by high throughput sequencing Mus musculus Source Type: research
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