TY - JOUR
T1 - Diagnosis and treatment of primary myelodysplastic syndromes in adults
T2 - Recommendations from the European LeukemiaNet
AU - Malcovati, Luca
AU - Hellström-Lindberg, Eva
AU - Bowen, David
AU - Adès, Lionel
AU - Cermak, Jaroslav
AU - Del Cañizo, Consuelo
AU - Della Porta, Matteo G.
AU - Fenaux, Pierre
AU - Gattermann, Norbert
AU - Germing, Ulrich
AU - Jansen, Joop H.
AU - Mittelman, Moshe
AU - Mufti, Ghulam
AU - Platzbecker, Uwe
AU - Sanz, Guillermo F.
AU - Selleslag, Dominik
AU - Skov-Holm, Mette
AU - Stauder, Reinhard
AU - Symeonidis, Argiris
AU - Van De Loosdrecht, Arjan A.
AU - De Witte, Theo
AU - Cazzola, Mario
PY - 2013/10/24
Y1 - 2013/10/24
N2 - Within the myelodysplastic syndrome (MDS) work package of the European LeukemiaNet, an Expert Panel was selected according to the framework elements of the National Institutes of Health Consensus Development Program. A systematic review of the literature was performed that included indexed original papers, indexed reviews and educational papers, and abstracts of conference proceedings. Guidelines were developed on the basis of a list of patient- and therapy-oriented questions, and recommendations were formulated and ranked according to the supporting level of evidence. MDSs should be classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires the evaluation of not only disease-related factors but also of those related to extrahematologic comorbidity. The assessment of individual risk enables the identification of fit patients withapoor prognosis who are candidates for up-front intensive treatments, primarily allogeneic stem cell transplantation. A high proportion of MDS patients are not eligible for potentially curative treatment becauseofadvanced age and/or clinically relevant comorbidities and poor performance status. In these patients, the therapeutic intervention is aimed at preventing cytopenia-related morbidity and preserving quality of life. A number of new agents are being developed for which the available evidence is not sufficient to recommend routine use. The inclusion of patients into prospective clinical trials is strongly recommended.
AB - Within the myelodysplastic syndrome (MDS) work package of the European LeukemiaNet, an Expert Panel was selected according to the framework elements of the National Institutes of Health Consensus Development Program. A systematic review of the literature was performed that included indexed original papers, indexed reviews and educational papers, and abstracts of conference proceedings. Guidelines were developed on the basis of a list of patient- and therapy-oriented questions, and recommendations were formulated and ranked according to the supporting level of evidence. MDSs should be classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires the evaluation of not only disease-related factors but also of those related to extrahematologic comorbidity. The assessment of individual risk enables the identification of fit patients withapoor prognosis who are candidates for up-front intensive treatments, primarily allogeneic stem cell transplantation. A high proportion of MDS patients are not eligible for potentially curative treatment becauseofadvanced age and/or clinically relevant comorbidities and poor performance status. In these patients, the therapeutic intervention is aimed at preventing cytopenia-related morbidity and preserving quality of life. A number of new agents are being developed for which the available evidence is not sufficient to recommend routine use. The inclusion of patients into prospective clinical trials is strongly recommended.
UR - http://www.scopus.com/inward/record.url?scp=84888240132&partnerID=8YFLogxK
U2 - 10.1182/blood-2013-03-492884
DO - 10.1182/blood-2013-03-492884
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C2 - 23980065
AN - SCOPUS:84888240132
SN - 0006-4971
VL - 122
SP - 2943
EP - 2964
JO - Blood
JF - Blood
IS - 17
ER -
