Myelodysplastic Syndromes, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology

Greenberg, Peter L.; Stone, Richard; Al‐Kali, Aref; Barta, Stefan K.; Bejar, Rafael; Bennett, John M.; Carraway, Hetty E.; Castro, Carlos M. de; Deeg, H. Joachim; DeZern, Amy E.; Fathi, Amir T.; Frankfurt, Olga; Gaensler, Karin; Garcia‐Manero, Guillermo; Griffiths, Elizabeth A.; Head, David R.; Horsfall, Ruth; Johnson, Robert A.; Juckett, Mark; Klimek, Virginia M.; Komrokji, Rami; Kujawski, Lisa; Maness, Lori J.; O’Donnell, Margaret; Pollyea, Daniel A.; Shami, Paul J.; Stein, Brady L.; Walker, Alison; Westervelt, Peter; Zeidan, Amer M.; Shead, Dorothy A.; Smith, Courtney

doi:10.6004/jnccn.2017.0007

Cited by 260 publications

(222 citation statements)

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“…Testing algorithms such as those advocated by the National Comprehensive Cancer Network and the European LeukemiaNet are helpful for this purpose. 71,72 Given the large percentage of individuals with CHIP, a somatic mutation is not sufficient to diagnose MDS, even in the context of prior therapy for another malignancy with radiation or cytotoxic drugs or a history of another marrow failure disorder such as aplastic anemia. 73 Like dysplasia or MDS-associated cytogenetic abnormalities, somatic mutations must have a known association with MDS and be accompanied by clinically meaningful cytopenias to consider an MDS diagnosis.…”

Section: Proposed Diagnostic Criteria For Mdsmentioning

confidence: 99%

Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes

Steensma

Bejar

Jaiswal

et al. 2015

Blood

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Recent genetic analyses of large populations have revealed that somatic mutations in hematopoietic cells leading to clonal expansion are commonly acquired during human aging. Clonally restricted hematopoiesis is associated with an increased risk of subsequent diagnosis of myeloid or lymphoid neoplasia and increased all-cause mortality. Although myelodysplastic syndromes (MDS) are defined by cytopenias, dysplastic morphology of blood and marrow cells, and clonal hematopoiesis, most individuals who acquire clonal hematopoiesis during aging will never develop MDS. Therefore, acquisition of somatic mutations that drive clonal expansion in the absence of cytopenias and dysplastic hematopoiesis can be considered clonal hematopoiesis of indeterminate potential (CHIP), analogous to monoclonal gammopathy of undetermined significance and monoclonal B-cell lymphocytosis, which are precursor states for hematologic neoplasms but are usually benign and do not progress. Because mutations are frequently observed in healthy older persons, detection of an MDS-associated somatic mutation in a cytopenic patient without other evidence of MDS may cause diagnostic uncertainty. Here we discuss the nature and prevalence of CHIP, distinction of this state from MDS, and current areas of uncertainty regarding diagnostic criteria for myeloid malignancies.

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Section: Proposed Diagnostic Criteria For Mdsmentioning

confidence: 99%

Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes

Steensma

Bejar

Jaiswal

et al. 2015

Blood

Self Cite

1,567

1,296

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show abstract

“…This algorithm is largely consistent with published practice guidelines of the National Comprehensive Cancer Network and, to a lesser extent, the more conservative guidelines of the European LeukemiaNet that reflect narrower regulatory approval of certain MDS drugs in Europe. 23,24 The only potentially curative therapy for MDS remains allogeneic hematopoietic stem (progenitor) cell transplantation (HSCT), but Figure 1. MDS treatment algorithm.…”

Section: Current Treatment Approachesmentioning

confidence: 99%

Recent developments in myelodysplastic syndromes

Bejar

Steensma

2014

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Once thought to be rare disorders, the myelodysplastic syndromes (MDS) are now recognized as among the most common hematological neoplasms, probably affecting >30 000 patients per year in the United States. US regulatory approval of azacitidine, decitabine, and lenalidomide between 2004 and 2006 seemed to herald a new era in the development of disease-modifying therapies for MDS, but there have been no further drug approvals for MDS indications in the United States in the last 8 years. The available drugs are not curative, and few of the compounds that are currently in development are likely to be approved in the near future. As a result, MDS diagnoses continue to place a heavy burden on both patients and health care systems. Incomplete understanding of disease pathology, the inherent biological complexity of MDS, and the presence of comorbid conditions and poor performance status in the typical older patient with MDS have been major impediments to development of effective novel therapies. Here we discuss new insights from genomic discoveries that are illuminating MDS pathogenesis, increasing diagnostic accuracy, and refining prognostic assessment, and which will one day contribute to more effective treatments and improved patient outcomes.

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“…Effects of erythropoiesis-stimulating agents on overall survival of IPSS low/INT-1 risk, transfusion independent myelodysplastic syndrome patients: a cohort study Clinical guidelines recommend the use of erythropoietin stimulating agents (ESAs) in lower risk anaemic myelodisplastic syndrome (MDS) patients [1][2][3][4] and two registration trials for ESAs have just been completed 5,6 . We conducted a retrospective study in MDS patients selected by the characteristics predictive of ESA response 7 , treated in common practice and enrolled in the Italian Network of regional MDS registries (ClinicalTrials.gov Identifier: NCT02808858)…”

mentioning

confidence: 99%

“…with no transfusion requirement [1][2][3][4] . The data from the Surveillance, Epidemiology, and End…”

mentioning

confidence: 99%

Effects of erythropoiesis-stimulating agents on overall survival of International Prognostic Scoring System Low/Intermediate-1 risk, transfusion-independent myelodysplastic syndrome patients: a cohort study

et al. 2018

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Myelodysplastic Syndromes, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology

Cited by 260 publications

References 0 publications

Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes

Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes

Recent developments in myelodysplastic syndromes

Effects of erythropoiesis-stimulating agents on overall survival of International Prognostic Scoring System Low/Intermediate-1 risk, transfusion-independent myelodysplastic syndrome patients: a cohort study

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