Development of epigenetic treatment in myelodysplastic syndromes

VernacularTitle:骨髓增生异常综合征表观遗传学治疗进展
Author: Feng XU ; Xiao LI
Publication Type:Journal Article
Keywords: Myelodysplastic syndromes; Epigenetic treatment; Demethylating agents; HDAC inhibitors
From: Journal of Leukemia & Lymphoma 2009;18(11):690-693
CountryChina
Language:Chinese
Abstract: It have been known that many epigenetic alterations palyed an important role in development of myelodysplastic syndromes (MDS). In contrast to genetic alterations, epigenetic alterations could be in principle pharmacologically reversed. Application of epigenetic drugs can reactivate inactivated suppressor genes. Epigenetic drugs mainly include demethylating agents and histone deacylase (HDAC) inhibitors, which are available in treatment. 5-AZA and decitabine as DNA demethylation agents have been approved by FDAof treatment in intermediate or high risk MDS, especially those old patients who are resistant to chemotherapy.HDAC inhibitors such as valproic acid are mostly employed in phase I trial, probably effective in treating low risk MDS, but treatment schedules and curative effects still have to be evaluated. The combination of demethylation agents and HDAC inhibitors may result in synergistic activity, but its therapeutic effect seems not to be superior to monotherapy of demethylation agents in current clinical trials, and it still need new clinical trials containing more cases and rational treatment schedules to identify safety and effect of combination.