British Society for Haematology guidelines for the management of adult myelodysplastic syndromes

Killick, Sally; Ingram, Wendy; Culligan, Dominic; Enright, Helen; Kell, Jonathan; Payne, Elspeth; Krishnamurthy, Pramila; Kulasekararaj, Austin; Raghavan, Manoj; Stanworth, Simon; Green, Simone; Mufti, Ghulam J.; Quek, Lynn; Cargo, Catherine; Jones, Gail; Mills, Juliet; Sternberg, Alex; Bowen, David

doi:10.1111/bjh.17612

Cited by 17 publications

(33 citation statements)

References 135 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If patients do not improve on appropriate antibiotics and the infectious work-up is noncontributory, it is important to consider other etiologies for respiratory failure. For example, pulmonary leukemic infiltration has been found to occur almost as frequently as pneumonia in this population on post-mortem examination [5]. Additionally, exacerbations of chronic lung disease, pulmonary edema, and drug toxicity can present in a similar fashion and are important differential diagnoses.…”

Section: Discussionmentioning

confidence: 93%

Azacitidine-Induced Pneumonitis in a Patient With Acute Myeloid Leukemia and Hyperleukocytosis

Litvin¹,

Dasgupta²,

Eldin³

et al. 2022

Cureus

View full text Add to dashboard Cite

Chemotherapy-related toxicity is a complex aspect of oncologic care. Pulmonary toxicity, in particular, poses a significant challenge, as it can have diverse presentations and can closely mimic other common complications of cancer treatment, such as infections. Azacitidine is an agent widely employed in high-risk myelodysplastic syndrome and acute myeloid leukemia. We present a case of azacitidine-induced pneumonitis, a rare adverse effect, in a 70-year-old patient with acute myeloid leukemia (AML) and hyperleukocytosis. After discontinuation of the drug and introduction of steroids, the patient had complete resolution of symptoms, highlighting the importance of identifying and addressing chemotherapy-induced pneumonitis.

show abstract

Section: Discussionmentioning

confidence: 93%

Azacitidine-Induced Pneumonitis in a Patient With Acute Myeloid Leukemia and Hyperleukocytosis

Litvin¹,

Dasgupta²,

Eldin³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Notably, the analysis by Lindsley et al suggested that more intensive conditioning may result in worse outcomes due to a higher risk of TRM without a reduction in relapse, presumably due to TP53 MDS being refractory to chemotherapy. Because of the low potential for cure, when available, transplant for TP53 mutated MDS should ideally be pursued in the context of a clinical trial focused on relapse reduction (17,29,53).…”

Section: Disease Related Prognostic Factorsmentioning

confidence: 99%

“…In patients with LR-MDS, life expectancy without transplant is on the order of years and, thus, the risks of alloBMT generally outweigh the potential benefits. However, some patients with LR-MDS based on IPSS or IPSS-R scoring should be considered for transplant in the setting of other high risk features including high risk clonal mutations such as TP53 , in the presence of significant bone marrow fibrosis, intolerance or contraindication to available therapies, and transfusion dependent patients who fail to achieve a hematologic response even after best available therapy ( 29 ). Additionally, because treatment options are limited after HMA and subsequent outcome are poor, our practice is to offer alloBMT to any patient with HMA failure regardless of disease risk stratification ( 30 ).…”

Section: Role and Considerations For Allogeneic Transplantmentioning

confidence: 99%

BMT for Myelodysplastic Syndrome: When and Where and How

Jain

Elmariah

2022

Front. Oncol.

View full text Add to dashboard Cite

Myelodysplastic syndromes (MDS) are a diverse group of hematological malignancies distinguished by a combination of dysplasia in the bone marrow, cytopenias and the risk of leukemic transformation. The hallmark of MDS is bone marrow failure which occurs due to selective growth of somatically mutated clonal hematopoietic stem cells. Multiple prognostic models have been developed to help predict survival and leukemic transformation, including the international prognostic scoring system (IPSS), revised international prognostic scoring system (IPSS-R), WHO prognostic scoring system (WPSS) and MD Anderson prognostic scoring system (MDAPSS). This risk stratification informs management as low risk (LR)-MDS treatment focuses on improving quality of life and cytopenias, while the treatment of high risk (HR)-MDS focuses on delaying disease progression and improving survival. While therapies such as erythropoiesis stimulating agents (ESAs), erythroid maturation agents (EMAs), immunomodulatory imide drugs (IMIDs), and hypomethylating agents (HMAs) may provide benefit, allogeneic blood or marrow transplant (alloBMT) is the only treatment that can offer cure for MDS. However, this therapy is marred, historically, by high rates of toxicity and transplant related mortality (TRM). Because of this, alloBMT is considered in a minority of MDS patients. With modern techniques, alloBMT has become a suitable option even for patients of advanced age or with significant comorbidities, many of whom who would not have been considered for transplant in prior years. Hence, a formal transplant evaluation to weigh the complex balance of patient and disease related factors and determine the potential benefit of transplant should be considered early in the disease course for most MDS patients. Once alloBMT is recommended, timing is a crucial consideration since delaying transplant can lead to disease progression and development of other comorbidities that may preclude transplant. Despite the success of alloBMT, relapse remains a major barrier to success and novel approaches are necessary to mitigate this risk and improve long term cure rates. This review describes various factors that should be considered when choosing patients with MDS who should pursue transplant, approaches and timing of transplant, and future directions of the field.

show abstract

“…Clinically, this is an aggressive disease, behaving similarly to acute myeloid leukemia (AML). Treatment with hypomethylating agents is aimed towards slow progression to AML and should be started as soon as possible [ 3 ]. On the other hand, 90% of low-risk MDS experience anemia, which can lead to symptoms of fatigue, cardiac morbidity, and cognitive impairment [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Ferric Carboxymaltose and Erythropoiesis-Stimulating Agent Treatment Reduces the Rate of Blood Transfusion in Refractory Anemia

Gidaro

Delitala

Berzuini

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Erythropoiesis-stimulating agents (ESAs) are used to treat refractory anemia (RA). Guidelines suggest iron supplementation for unresponsive patients, regardless of iron deficiency. The primary aim of this study was to evaluate the effect of iron supplementation with ferric carboxymaltose (FCM) on the reduction of red blood cell transfusion (RBCT) rate in transfusion-dependent RA patients. Methods: This was a prospective quasi-randomized study, wherein patients were randomly assigned into three groups: (A) ESAs alone, (B) ferric gluconate (FG) and ESAs, and (C) FCM and ESAs. Hemoglobin and ferritin levels, as well as the number of RBCTs at 4 and 28 weeks were compared. Economic evaluation was also performed. Results: A total of 113 RA patients were enrolled. In total, 43 were treated with intravenous FG and ESAs, 38 with FCM and ESAs, and 32 with ESAs alone. At both follow-ups, erythropoietic response was increased in those receiving iron as compared with those with ESAs alone (p = 0.001), regardless of the type of iron. At one month, ferritin levels were higher in the FCM and ESA groups (p = 0.001). RBCTs were lower in both iron groups. The less costly treatment strategy was FCM, followed by FG, and lastly ESAs. Conclusion: Addition of iron to ESAs in RA reduced RBCT requirement and improved hemoglobin values.

show abstract

British Society for Haematology guidelines for the management of adult myelodysplastic syndromes

Cited by 17 publications

References 135 publications

Azacitidine-Induced Pneumonitis in a Patient With Acute Myeloid Leukemia and Hyperleukocytosis

Azacitidine-Induced Pneumonitis in a Patient With Acute Myeloid Leukemia and Hyperleukocytosis

BMT for Myelodysplastic Syndrome: When and Where and How

Ferric Carboxymaltose and Erythropoiesis-Stimulating Agent Treatment Reduces the Rate of Blood Transfusion in Refractory Anemia

Contact Info

Product

Resources

About