Bonadies, Nicolas (2017). MANAGEMENT OF ADULT PATIENTS WITH MYELODYSPLASTIC SYNDROMES. EMJ hepatology(4.0), pp. 104-112. European Medical Group
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The myelodysplastic syndromes (MDS) form a heterogeneous group of clonal disorders with an increasing
incidence in the elderly population and an emerging impact on healthcare resources. MDS are caused
by gene mutations affecting the haematopoietic stem cells, leading to ineffective haematopoiesis,
characterised by dysplasia and cytopenia, and a propensity to evolve towards secondary acute myeloid
leukaemia (AML). Accurate diagnosis and risk assessment are essential for the correct treatment allocation.
In lower-risk MDS patients, median survival reaches 3–8 years and mortality is mainly caused by cytopenia
(cardiovascular events, infections, and bleeding). Therefore, the treatment for these patients should be
focussed on reduction of disease-related complications, disease progression, and improvement of quality
of life. In contrast, in higher-risk MDS patients, median survival ranges from 1–3 years and death from
transformation to AML exceeds non-leukaemic mortality. Treatment should be aimed to delay progression
to AML and improve overall survival. Allogeneic haematopoietic stem cell transplant remains the only
curative option for higher-risk MDS patients. However, only a minority of patients are eligible for such
intensive treatment. Consequently, most patients are managed with supportive care and palliative
treatment, including growth factors, immune-modulators, and hypomethylating agents. Since elderly
patients with chronic cytopenia are frequently seen in general practice, awareness of the wide spectrum
of presentations of MDS and potential courses of lower and higher-risk diseases are important for
primary healthcare physicians.
Item Type: |
Journal Article (Review Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene) |
UniBE Contributor: |
Bonadies, Nicolas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2053-4221 |
Publisher: |
European Medical Group |
Language: |
English |
Submitter: |
Katrin Kölliker-Schütz |
Date Deposited: |
05 Mar 2018 17:10 |
Last Modified: |
05 Dec 2022 15:10 |
BORIS DOI: |
10.7892/boris.110110 |
URI: |
https://boris.unibe.ch/id/eprint/110110 |
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