Treatment strategies of low-risk myelodysplastic syndromes
10.3760/cma.j.issn.1009-9921.2018.03.005
- VernacularTitle:低危骨髓增生异常综合征的治疗策略
- Author:
Xudong TANG
1
;
Lu ZHANG
;
Xiupeng YANG
;
Yufeng TANG
;
Dexiu WANG
Author Information
1. 中国中医科学院西苑医院血液科
- Keywords:
Myelodysplastic syndromes;
Low-risk;
Therapy
- From:
Journal of Leukemia & Lymphoma
2018;27(3):145-148
- CountryChina
- Language:Chinese
-
Abstract:
The support treatment of low-risk myelodysplastic syndromes (MDS) patients whose revised international prognostic score system (IPSS-R) is defined as 3.5 points remains the main treatment. The erythropoiesis stimulating agent (ESA) is the best choice for patients with del (5q) MDS as long as the endogenous erythropoietin (EPO) level is less than 500 U/L (preferably<200 U/L). The application of EPO for patients with treatment failure or relapsed after transfusion, chooses are immunosuppressant, transforming growth factor beta inhibitors and lenalidomide. Del (5q) syndrome could benefit from lenalidomide, and some patients after discontinuation of treatment still have been stable in peripheral blood. Thrombocytopenia caused serious hemorrhage rarely; thrombopoietin receptor analogs could reduce bleeding and improve the platelet count. These drugs can be used in patients with bone marrow blast counts of < 0.05. If treatment failed or advanced to high-risk MDS or transformed to acute myeloid leukemia, allogeneic hematopoietic stem cell transplantation might be required. Combined with reports in the 59th American Society of Hematology (ASH) Annual Meeting, this article describes the treatment strategies for low-risk MDS.
