RISK-ADAPTED THERAPY OF MYELODYSPLASTIC SYNDROMES
Abstract
Myelodysplastic syndromes (MDS) are a heterogeneous and complex group of clonal hematological neoplasms arising from a hematopoietic stem cell, and characterized by ineffective hematopoiesis, resulting from increased apoptosis in the bone marrow. Epigenetic changes are reported as key mutations in the case of MDS. Its incidence in Russia is documented as 2.0 new MDS diagnoses per 100,000 people and its incidence increases with age. Current diagnostic WHO classification of MDS was revised in 2016. The choice of therapy depends on the morphological MDS subtypes, the risk of its transformation into acute myeloid leukemia, age and general condition of the patient. Lenalidomide is an antineoplastic drug with the most impressive clinical activity, including achievement of transfusion independence and cytogenetic responses in MDS patients who harbor a deletion of the long arm of chromosome 5 (5q-). The hypomethylating agent azacitidine prolongs survival among patients with higher risk MDS compared with conventional care. In this article, we review the new classification of WHO, features of estimating the prognosis, mechanisms of action of lenalidomide and hypomethylating agents, and also discuss the most recent clinical data regarding its use in patients with MDS.
About the Authors
G. A. Dudina
ГБУЗ «Московский клинический научный центр им. А.С. Логинова» ДЗМ
Russian Federation
Russian Federation
S. V. Semochkin
ФГБОУ ВО «Российский национальный медицинский исследовательский университет им. Н.И. Пирогова» Минздрава России
Russian Federation
Russian Federation
B. A. Bakirov
ФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава России»
Russian Federation
Russian Federation
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Review
For citations:
Dudina G.A., Semochkin S.V., Bakirov B.A. RISK-ADAPTED THERAPY OF MYELODYSPLASTIC SYNDROMES. Bashkortostan Medical Journal. 2018;13(2):96-101. (In Russ.)
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