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treatment of myelodysplastic syndromes

must read: Clinical decision-making and treatment of myelodysplastic syndromes

(Am J Hematol 2012;87:692): intensity based on IPSS-R (qv), age, performance status (PS)

  • Poor PS, any risk → supportive care (transfusions, G-CSF, Epo, TPO-mimetic, abx prn)

  • Very low/low risk (IPSS-R) → ESA if Epo <500; lenalidomide (esp. for 5q synd.; Blood 2011;118:3765); luspatercept (MDS-RS). TPO-mimetic agents, transfusions.

  • Interm/high risk (IPSS-R) → allogeneic HSCT if medically fit DNA methyl-transferase inh : HMA

    • aza-CI-tadine subcutaneous
    • de-CI-tabine IV (Lancet Oncol 2009;10:223)
    • oral decitabine/cedazuridine

Hypoplastic MDS 的治療方案是什麼?

  • 摘要:Hypoplastic MDS 的治療方案包括免疫抑制治療(CsA,ATG)和造血幹細胞移植(HSCT)。
  • 原文:Hypoplastic MDS (rare) → consider immunosuppression (CsA, ATG), HSCT