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