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low-risk myelodysplastic syndromes

Nikolaos Gardikas, Myrofora Vikentiou, Evgenia Konsta, Christos K Kontos, Sotirios G Papageorgiou, Aris Spathis, Efthimia Bazani, Anthi Bouchla, Violetta Kapsimali, Katherina Psarra, Periklis Foukas, George Dimitriadis, Vasiliki Pappa
BACKGROUND: Myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders with unknown aetiology. Multiparameter flow cytometry (MFC) is being evaluated for the diagnosis and prognosis of MDS. METHODS: In the present study, five-color MFC was performed on bone marrow aspirates of 50 untreated patients, newly diagnosed with MDS and 27 age matched control samples. Patients were classified according to World Health Organization 2016, International Prognostic Scoring System (IPSS), and Revised IPSS (IPSS-R)...
October 17, 2018: Cytometry. Part B, Clinical Cytometry
Zhen Ping, Si Chen, Sjoerd J F Hermans, Keane J G Kenswil, Jacqueline Feyen, Claire van Dijk, Eric M J Bindels, Athina M Mylona, Niken M Adisty, Remco M Hoogenboezem, Mathijs A Sanders, Eline M P Cremers, Dicky J Lindenbergh-Kortleve, Janneke N Samsom, Arjan A van de Loosdrecht, Marc H G P Raaijmakers
No abstract text is available yet for this article.
October 12, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Yasuhito Nannya
Recent advances in drug treatment for higher-risk myelodysplastic syndromes (MDS) have focused on DNA hypomethylating agents (HMAs). Azacitidine (AZA), a representative HMA available in Japan, has demonstrated a survival benefit over conventional treatment. However, unsatisfactory treatment profiles of AZA exemplified by a low response rate of <20% complete remission (CR), a short duration of response (usually <1 year), and dismal outcomes after the failure to fulfil unmet needs in AZA treatments have highlighted the urgent need for the development of novel therapeutic modalities...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Yasuyoshi Morita
Myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders characterized by cytopenia and leukemic transformation. Allogeneic hematopoietic stem cell transplantation is the only potential curative therapy for MDS; however, the first treatment option for transfusion-independent patients with low-risk MDS remains limited. Recently, lenalidomide has become available for patients with low-risk MDS and symptomatic anemia with del (5q) (5q-syndrome), darbepoetin (DA) for those with anemia without del (5q), and azacitidine for those with DA-resistant anemia or anemia with thrombocytopenia...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Chen Mei, Yanling Ren, Xinping Zhou, Li Ye, Liya Ma, Yingwan Luo, Peipei Lin, Weilai Xu, Chenxi Lu, Haiyang Yang, Wenjuan Yu, Liping Mao, Juying Wei, Jie Jin, Hongyan Tong
It is controversial whether acute myeloid leukemia (AML) patients with 20-29% bone marrow (BM) blasts should be considered AML or myelodysplastic syndromes (MDS). We retrospectively studied 382 patients, including 108 AML with 20-29% BM blasts (AML20-29), 210 AML with ≥30% BM blasts (AML ≥ 30), and 64 MDS with 10-19% BM blasts (MDS-EB2). We found that AML20-29 were more similar to MDS-EB2 in terms of advanced age, less blood count, the increased presence of poor-risk cytogenetics. The frequency of mutated genes in AML20-29 had both the characters of AML and MDS...
October 10, 2018: Leukemia & Lymphoma
Sophie Park, Olivier Kosmider, Frédéric Maloisel, Bernard Drenou, Nicolas Chapuis, Thibaud Lefebvre, Zoubida Karim, Hervé Puy, Anne Sophie Alary, Sarah Ducamp, Frédérique Verdier, Cécile Bouilloux, Alice Rousseau, Marie-Christine Jacob, Agathe Debliquis, Agnes Charpentier, Emmanuel Gyan, Bruno Anglaret, Cecile Leyronnas, Selim Corm, Bohrane Slama, Stephane Cheze, Kamel Laribi, Shanti Amé, Christian Rose, Florence Lachenal, Andrea Toma, Gian Matteo Pica, Martin Carre, Frédéric Garban, Clara Mariette, Jean-Yves Cahn, Mathieu Meunier, Olivier Herault, Pierre Fenaux, Orianne Wagner-Ballon, Valerie Bardet, Francois Dreyfus, Michaela Fontenay
Erythropoiesis-stimulating agents are generally the first line of treatment of anemia in lower risk myelodysplastic syndrome patients. We prospectively investigated the predictive value of somatic mutations, and biomarkers of ineffective erythropoiesis including flow cytometry RED score, serum GDF-15, and hepcidin levels. Inclusion criteria were: Erythropoiesis stimulating agents naive, IPSS low or intermediate-1 MDS with Hemoglobin level< 10g/dl, red blood cell transfusion-dependent or not. Patients received epoetin zeta 40 000 IU/week and erythroid response (IWG 2006 criteria) was assessed at week 12...
October 4, 2018: Haematologica
Sarah A Buckley, Mary-Elizabeth Percival, Megan Othus, Anna B Halpern, Emily M Huebner, Pamela S Becker, Carole Shaw, Mazyar Shadman, Roland B Walter, Elihu H Estey
Patients with newly diagnosed (ND) and relapsed/refractory (RR) acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS, ≥10% blasts) often receive intensive chemotherapy at diagnosis and relapse. We retrospectively identified 365 patients and categorized the reasons for receiving treatment off study (medical, logistical, or unclear). The pretreatment characteristics of the on and off study groups were similar. Rates of the complete remission (CR) without measurable residual disease were significantly higher for ND patients treated on versus off study (61% versus 35%), but CR rates and survival were low for all RR patients regardless of study assignment...
October 2, 2018: Leukemia & Lymphoma
Chun-Hong Xie, Min Wei, Fei-Yan Yang, Fu-Zhen Wu, Lei Chen, Jian-Kun Wang, Qin Liu, Jin-Xiong Huang
Background: Lenalidomide is effective for the treatment of low-risk myelodysplastic syndromes with deletion 5q abnormalities. However, whether lenalidomide leads to a significant improvement in treatment response and overall survival (OS) in cases of acute myeloid leukemia (AML) remains controversial. A systematic review and a meta-analysis were performed to evaluate the efficacy and safety of lenalidomide in the treatment of AML. Methods: Clinical studies were identified from the Cochrane Central Register of Controlled Trials, PubMed, Embase, and ClinicalTrials...
2018: Cancer Management and Research
Peipei Lin, Yanling Ren, Xiaomei Yan, Yingwan Luo, Hua Zhang, Meenu Kesarwani, Jiachen Bu, Di Zhan, Yile Zhou, Yuting Tang, Shuanghong Zhu, Weilai Xu, Xinping Zhou, Chen Mei, Liya Ma, Li Ye, Chao Hu, Mohammad Azam, Wei Ding, Jie Jin, Gang Huang, Hongyan Tong
Although cytarabine has been widely considered as one of the chemo drugs for high-risk myelodysplastic syndromes, the overall response rate is only 20%~30%. Nuclear factor erythroid 2-related factor 2 (NFE2L2, also called NRF2) has been shown to play a pivotal role in preventing cancer cells from being affected by chemotherapy. However, it is not yet known whether NFE2L2 has utility as a prognostic biomarker in myelodysplastic syndromes, or whether elevated NFE2L2 levels are associated with cytarabine resistance...
September 27, 2018: Haematologica
Piyanuch Kongtim, Simrit Parmar, Denái R Milton, Jorge Miguel Ramos Perez, Gabriela Rondon, Julianne Chen, Abhishek R Chilkulwar, Gheath Al-Atrash, Amin Alousi, Borje S Andersson, Jin S Im, Chitra M Hosing, Qaiser Bashir, Issa Khouri, Partow Kebriaei, Betul Oran, Uday Popat, Richard Champlin, Stefan O Ciurea
Outcomes after allogeneic stem-cell transplantation (AHSCT) are influenced by both disease- and patient-related factors. Here, we developed a novel prognostic model, hematopoietic cell transplant-composite risk (HCT-CR), by combining the refined disease risk index (DRI-R) and hematopoietic stem-cell transplant comorbidity/age index (HCT-CI/Age) to predict post-transplant survival for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). The analysis included 942 AML/MDS patients treated with AHSCT...
September 26, 2018: Bone Marrow Transplantation
J Brian Lanier, James J Park, Robert C Callahan
Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to associated conditions, such as blood loss, or related to decreased oxygen-carrying capacity, such as weakness, fatigue, and shortness of breath. Causes of anemia in older adults include nutritional deficiency, chronic kidney disease, chronic inflammation, and occult blood loss from gastrointestinal malignancy, although in many patients the etiology is unknown...
October 1, 2018: American Family Physician
Yasmin Abaza, Juliana E Hidalgo-Lopez, Srdan Verstovsek, Elias Jabbour, Farhad Ravandi, Gautam Borthakur, Zeev Estrov, Yesid Alvarado, Jan Burger, Heather Schneider, Kelly A Soltysiak, Yue Wei, Hagop M Kantarjian, Carlos E Bueso-Ramos, Guillermo Garcia-Manero
Therapeutic options for patients with lower-risk myelodysplastic syndrome (MDS) who have failed prior therapies are limited particularly after hypomethylating agent. Several studies have indicated that deregulation of innate immunity signaling is critical in the pathogenesis of MDS. This process involves Toll-like receptor stimulation, cytokine overexpression, and nuclear factor-kB (NF-kB) activation. Since ruxolitinib, a JAK1/JAK2 inhibitor, suppresses NF-kB expression, we conducted a phase 1 dose-escalation study to determine the safety and efficacy of ruxolitinib in previously treated lower-risk MDS patients with evidence of NF-kB activation...
October 2018: Leukemia Research
Jehad Almasri, Hassan B Alkhateeb, Belal Firwana, Mohamad Bassam Sonbol, Moussab Damlaj, Zhen Wang, M Hassan Murad, Aref Al-Kali
BACKGROUND: Hypomethylating agents (HMA), azacitidine, and decitabine are frequently used in the management of myelodysplastic syndromes (MDS). However, there are no clinical trials that have directly compared these agents. We conducted a systematic review and indirectly compared the efficacy of azacitidine to decitabine in MDS. METHODS: We conducted a comprehensive search of several databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus) through June 28, 2018, without language or time restrictions...
September 19, 2018: Systematic Reviews
Youssoufa M Ousseine, Phyllis N Butow, Pierre Fenaux, Rebecca Dring, Patrick Festy, Léa Restivo, Norbert Vey, Julien Mancini
MDS is a complex and potentially severe disease which can trigger psychological distress. A lack of information received and understood about MDS may also arouse feelings of distress. Low health literacy (HL) might play a role particularly among older patients. Our aim was to assess MDS-related distress and to study the factors associated with it, including medical and non-medical factors such as HL. A self-administered questionnaire was mailed to all members of French and Australian patients' national MDS associations...
September 5, 2018: Leukemia Research
Koji Kawamura
HLA 1-locus-mismatched unrelated donors (1MMUD) are used in allogeneic hematopoietic stem cell transplantation (allo-HCT) for patients who lack an HLA-matched donor. Here we retrospectively reviewed 3,313 patients with acute leukemia or myelodysplastic syndrome who underwent bone marrow transplantation from an HLA allele-matched unrelated donor (MUD) or 1MMUD in 2009-2014. We compared the outcomes of MUD (n=2,089) and 1MMUD with antithymocyte globulin [ATG; 1MM-ATG (+) ; n=109] with those of 1MMUD without ATG [1MM-ATG (-) ; n=1,115]...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Dame Idossa, Terra L Lasho, Christy M Finke, Rhett P Ketterling, Mrinal M Patnaik, Animesh Pardanani, Naseema Gangat, Ayalew Tefferi
We examined the influence of mutations and karyotype on conventional treatment response, specifically hematological improvement in anemia, in primary myelodysplastic syndromes (MDS). Cytogenetic and next generation sequencing (NGS)-derived mutation information was available in 357 patients (median age 74 years; 70% males); the revised international prognostic scoring system risk distribution was very high in 11%, high 15%, intermediate 17%, low 40% and very low 16%. At least one mutation was detected in 81% of patients; most frequent were SF3B1 (32%), ASXL1 (27%), TET2 (24%) and U2AF1 (15%)...
November 2018: American Journal of Hematology
Cheng-Ming Fei, Juan Guo, You-Shan Zhao, Si-Da Zhao, Qing-Qing Zhen, Lei Shi, Xiao Li, Chun-Kang Chang
BACKGROUND: Hyaluronan (HA), a major component of the extracellular matrix, has been proven to play a crucial role in tumor progression. However, it remains unknown whether HA exerts any effects in myelodysplastic syndromes (MDS). METHODS: A total of 82 patients with MDS and 28 healthy donors were investigated in this study. We firstly examined the bone marrow (BM) serum levels of HA in MDS by radioimmunoassay. Then we determined HA production and hyaluronan synthase (HAS) gene expression in BM mesenchymal stromal cells (MSC) and mononuclear cells derived from MDS patients...
August 24, 2018: Journal of Translational Medicine
Silvia Maria Meira Magalhães, Elvira Deolinda Rodrigues Pereira Velloso, Renata Buzzini, Wanderley Marques Bernardo
No abstract text is available yet for this article.
July 2018: Hematology, transfusion and cell therapy
Elvira Deolinda Rodrigues Pereira Velloso, Silvia Maria Meira Magalhães, Maria de Lourdes Lopes Ferrari Chauffaille, Renata Buzzini, Wanderley Marques Bernardo
No abstract text is available yet for this article.
July 2018: Hematology, transfusion and cell therapy
Raphael Itzykson, Simon Crouch, Erica Travaglino, Alex Smith, Argiris Symeonidis, Eva Hellström-Lindberg, Guillermo Sanz, Jaroslav Čermák, Reinhard Stauder, Chiara Elena, Ulrich Germing, Moshe Mittelman, Saskia Langemeijer, Krzysztof Mądry, Aurelia Tatic, Mette Skov Holm, Antonio Medina Almeida, Aleksandar Savic, Njetočka Gredelj Šimec, Elisa Luño, Dominic Culligan, Agnes Guerci-Bresler, Luca Malcovati, Corine van Marrewijk, David Bowen, Theo de Witte, Pierre Fenaux
Prognosis of lower-risk (International Prognostic Scoring System [IPSS] low/intermediate-1) myelodysplastic syndrome (MDS) is heterogeneous and relies on steady-state assessment of cytopenias. We analyzed relative drops in neutrophil and platelet counts during the first 6 months of follow-up of lower-risk MDS patients. We performed a landmark analysis of overall survival (OS) of lower-risk MDS patients prospectively included in the European LeukaemiaNet MDS registry having a visit at 6 ± 1 month from inclusion to assess the prognostic relevance of relative drops in neutrophils and platelets, defined as (count at landmark - count at inclusion)/count at inclusion...
August 28, 2018: Blood Advances
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