View
Myelodysplastic Syndromes
Deep Dive into the Management of Myelodysplastic Syndromes
Session Details: Myelodysplastic Syndromes: What We Have and What We Want
Speaker details: Dr. Uwe Platzbecker, Dr. Hetty Carraway, Dr. Bart Scott
Myelodysplastic syndromes (MDS) constitute a heterogeneous set of disorders, the management of which remains complex. Myelodysplastic syndrome has a variety of clinical presentations with mostly broad-based approaches for treatment.1 The identification of somatic mutations in MDS has generated hope for targeted therapies.
1. Risk Stratification in Myelodysplastic Syndromes 1-3
The recent World Health Organization (WHO) classification has incorporated genetic parameters into the diagnostic workup of patients with MDS.
The current MDS prognostic scoring systems are only an approximation in personalized risk stratification.
Putting the puzzle together will require the integration of complex molecular and immunological interactions with clinical variables.
An artificial intelligence-based classification and prognosis system that integrates immunological, genomic, and clinical information will push patient stratification to the next level.
2. Therapy for Lower-Risk Myelodysplastic Syndromes 1,4
Transfusion and antimicrobials are reasonable for lower risk (LR) MDS
Erythropoietinstimulating agent (ESA) therapy is typically the first step.
Luspatercept was approved for transfusiondependent MDS with ring sideroblasts
Lenalidomide is the standard care for transfusiondependentdeletion 5q (del (5q)) LRMDS.
3. Therapy for High-Risk Myelodysplastic Syndromes 5
Intermediate high-risk (HR) MDS patients should be referred for transplantation.
The results for solitary hypomethylating agent (HMA)therapy are suboptimal.
Several HMAs are being studied, such as venetoclax, magrolimab, and pevonedistat.
Patients in whom HMA has failed should be considered for clinical trials or transplantation.
