Novel aproaches in therapy of low-risk patients with myelodysplastic syndrome


Authors: A. Jonášová
Authors‘ workplace: I. interní klinika 1. lékařské fakulty UK a VFN, Praha
Published in: Transfuze Hematol. dnes,15, 2009, No. 2, p. 114-120.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Myelodysplastic syndrome is one of the most frequent haematological diseases. Its incidence is on the rise due to the increasing life expectancy of the population and also probably due to the increasing exposure to various toxic substances. Treatment of this disease, though, remains difficult. In terms of therapy, we most frequently divide MDS into low and very high-risk patients. In our review, we deal with some of the novel therapeutic approaches and preparations used in the low risk patients, also taking into account that these should become available to our patients in the foreseeable future. We first focus on growth factors, especially erythropoiesis stimulating proteins, and the fundamentals of treatment based on current clinical trials and new preparations. We then present an overview of chelation therapy, including new guidelines and a brief summary of our own results and experience. This is followed by information regarding completely novel and successful therapeutic approaches, namely the use of immunomodulatory and demethylation therapy, and a description of these preparations. Last but not least, we will direct our attention to immunosuppressive therapy, an already well-known modality, yet with clearer criteria of patient selection.

Key words:
myelodysplastic syndrome, growth factors, chelation therapy, hypomethylation agents, immunomodulation, immunosuppression


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Haematology Internal medicine Clinical oncology
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