New progress of myelodysplastic syndomes (MDS) in the 55th ASH annual meeting on allogeneic transplantation were reviewed.Even though the IPSS was developed mainly to determine the prognostic risk in newly diagnosed MDS patients,its predictive value concerning posttransplantation outcome has bcen confirmed in several studies.According to a decision model published a decade ago,patients with intermediate-2 or high-risk MDS by IPSS criteria should be considered for hematopoietic cell transplantation (HCT) at the time of diagnosis if an HLA-matched donor is available at this time.Given the age of most MDS patients,therapeutic interventions are per se often limited to rather nonintensive treatment approaches.This article reviews the current evidence for allogeneic HCT as a therapeutic option in the context of disease-specific characteristics and current available alternative treatments.

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Plant alkaloids have anti-tumor activities.In recent years,the anti-tumor mechanisms of plant alkaloid are demonstrated to be related to the block of tumor cell cycle,the induction of tumor cell apoptosis,the inhibition of tumor angiogenesis and multi-drug resistance.In addition,most recently,plant alkaloids are found to inhibit telomerase activity and induce autophagy.Therefore,plant alkaloids may be developed into a sort of potential antitumor drugs.

New progress of myelodysplastic syndomes (MDS) in the 55th ASH annual meeting on 5-azacytidine and decitabine was reviewed.Except in older females,the survival time for a diagnosis of MDS in the United States does not seem to have substantially improved since the introduction of 5-azacytidine into the market in 2004.However,clinical and mechanism data suggest that judicious,mechanism-based application and optimization of these agents will have increasingly meaningful impact.Moreover,these drugs are exemplars of an inspiring alternative to the traditional cytotoxic paradigm and should pave the way for additional relatively nontoxic but broadly effective agents.

Replacement therapy is the most effective method for the treatment of end-stage liver disease,and decellularized liver bioscaffold broadens the research field of the replacement therapy.The present liver bioscaffold preparation is to perfuse chemical reagents (detergents,enzymes,et al) into the vascular structure of the liver under certain physical conditions,so as to remove cellular components and retain extracellular matrix and microvascular structure.Cells were reseeded into the decellularized liver scaffold to obtain the recellularized liver,which can be cultured and evaluated in vitro or in vivo by observing the adhesion of seeded cells,detecting the synthesis and secretion of the recellularized liver.Currently,the selection of seed cells,recellularization protocol and recellularized liver transplantation are still under exploration.In this review,the preparation,evaluation,detection and application of the decellularized liver bioscaffold are introduced for the further experimental study and clinical research.

The research progresses of iron homeostasis and the diagnosis of hereditary iron overload in the 56th American Society of Hematology (ASH) annual meetings were reviewed.Over the last 2 decades,the discovery of mutations in genes leading to hereditary disorders of iron overload,iron deficiency,and iron maldistribution had accelerated our understanding of human iron homeostasis.This article provided an updated overview of the human iron cycle,regulation of iron homeostasis,how perturbations in these homeostatic mechanisms led to iron overload disease and strategies for the diagnosis of hereditary iron overload.

Progress of guidelines for quantifying iron overload in the 56th American Society of Hematology (ASH) annual meetings was reviewed.This article reviewed the use of historical data,serological measures,and MRI to estimate somatic iron burden.Before chelation therapy utilization,transfusional volume was an accurate method for estimating liver iron burden,whereas transferrin saturation reflected the risk of extrahepatic iron deposition.Liver biopsy was invasive and plagued by sampling variability.In the current study,we recommended annual liver iron concentration to be measured by MRI for all patients on chronic transfusion therapy.And it was important to measure cardiac T2* by MRI every 6-24 months depending on the clinical risk of cardiac iron deposition.Recent validation data for pancreas and pituitary iron assessments was also presented,while the further confirmatory data was suggested before these techniques could be recommended for routine clinical use.

New progresses of timing of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndrome (MDS) and aplastic anemia in the 56th ASH annual meetings were reviewed.Allo-HSCT for MDS was a potentially curative procedure,but it was associated with a significant risk of morbidity and mortality.With the recent approval of disease-modifying agents,the appropriate timing of alloHSCT needed to be addressed.For low and intermediate-1 IPSS risk groups,the decision to delay HSCT from the time of diagnosis maximized overall survival.For patients with intermediate-2 and high-risk disease,immediate HSCT at the time of diagnosis was associated with a greater number of life-years than HSCT at a delayed time point.The methods that underwent HSCT were after azacitidine,leukemia-type induction chemotherapy,or both.for severe aplastic anemia (SAA),HSCT was a proven cure,but HLA-matched sibling donors were found in fewer than 25 ％ of newly diagnosed patients.The use of early unrelated donor HSCT was an evolving concept that will became more accepted as improvements in HSCT outcomes continued.Moving forward,HLA-matched related and unrelated donor HSCT will likely become the treatment of choice for most patients with higher-risk MDS and newly diagnosed SAA.

New progress of guidelines for novel targets to iron overload in the 56th American Society of Hematology (ASH) annual meeting was reviewed.β-thalassemia and hereditary hemochromatosis disorders,and inappropriately low levels of the liver hormone hepcidin are responsible for the increased iron absorption,leading to toxic iron accumulation in many organs.Several studies have shown that targeting iron absorption could be beneficial to reducing or preventing iron overload in these 2 disorders.New approaches target Tmprss6.Additional strategies in β-thalassemia are showing beneficial effects in ameliorating ineffective erythropoiesis and anemia.The goal of this review is to discuss the major factors controlling iron metabolism and erythropoiesis and to discuss potential novel therapeutic approaches to reduce or prevent iron overload in these 2 disorders and ameliorate anemia in β-thalassemia.

New progress of guidelines for established and novel agents for myelodysplastic syndromes (MDS) in the 56th American Society of Hematology (ASH) annual meetings was reviewed.MDS was the most commonly diagnosed myeloid malignancy.According to prognostic scoring systems,the MDS patients were divided into lower-risk and higher-risk group.The goal of treatment for lower-risk patients is transfusions minimization and life quality optimization,while the goal of treatment for higher-risk patients is transformation to acute leukemia delay and life prolongation.The lower-risk patients with isolated cytopenia are treated with erythropoiesis-stimulating agents or growth factors.For patients with the del (5q) cytogenetic abnormality or those who were failure in these initial treatment,lenalidomide or experimental agents may be administrated.Lower-risk patients with multiple cytopenia may be treated with immunosuppressive drugs or low-dose hypomethylating agents.For patients with higher-risk disease,hypomethylating agents are the preferred initial treatment approach,with evaluation for hematopoietic cell transplantation at diagnosis.