Outlook and Management of Patients with Myelodysplastic Syndromes Failed by Hypomethylating Agents.

Abstract:

:The DNA hypomethylating agents (HMAs) azacitidine and decitabine are currently the most frequently administered disease-modifying therapies for patients with higher-risk myelodysplastic syndromes (MDS). However, azacitidine and decitabine are not curative, the median response duration is 11-15 months, and only 10-20 % of patients experience complete hematologic and cytogenetic response. Moreover, once an HMA fails the patient, the prognosis is poor, with a median survival of less than 6 months unless the patient undergoes hematopoietic stem cell transplantation (HSCT). Recent insights into the genetic basis of MDS have enhanced biological understanding and prognostication accuracy, but these developments have not yet led to regulatory approval of new therapies. While there are multiple potential approaches to patients with MDS for whom HMAs have failed, including supportive care alone, cytotoxic therapy, lenalidomide, histone deacetylase inhibitors, and HSCT, favorable responses to these approaches are limited and new therapies are greatly needed. Here, we review clinical and biological data about the population of patients failed by HMAs, evaluate currently available approaches to patients in this clinical situation, and discuss prospects for development of novel active agents.

journal_name

Curr Hematol Malig Rep

authors

Roberts DA,Steensma DP

doi

10.1007/s11899-015-0273-2

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

318-28

issue

3

eissn

1558-8211

issn

1558-822X

journal_volume

10

pub_type

杂志文章,评审
  • Pathogenesis of Enteropathy-Associated T Cell Lymphoma.

    abstract:PURPOSE OF REVIEW:To provide an update on the pathogenesis of enteropathy-associated T cell lymphoma (EATL) and its relationship with refractory celiac disease (RCD), in light of current knowledge of immune, genetic, and environmental factors that promote neoplastic transformation of intraepithelial lymphocytes (IELs)....

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-018-0459-5

    authors: Chander U,Leeman-Neill RJ,Bhagat G

    更新日期:2018-08-01 00:00:00

  • The Critical Role of Imaging in the Management of Multiple Myeloma.

    abstract::Multiple myeloma (MM) is characterized by abnormal proliferation of plasma cells in the bone marrow leading to symptoms of anemia, renal failure, hypercalcemia, and bone lesions. Bone imaging is critical for the diagnosis, staging, assessment for the presence and extent of bone lesions, and initial treatment of MM. Sk...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-017-0379-9

    authors: Raza S,Leng S,Lentzsch S

    更新日期:2017-06-01 00:00:00

  • Choosing Wisely® in Hematology: Have We Made a Difference?

    abstract:PURPOSE OF REVIEW:The Choosing Wisely® initiative, led by the American Board of Internal Medicine Foundation in collaboration with national professional medical societies, aims to help patients choose care that is essential, free from harm, and evidence-based. The American Society of Hematology has advocated practices ...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-020-00593-2

    authors: Hilal T,Munoz J

    更新日期:2020-08-01 00:00:00

  • Novel Immunotherapies for T Cell Lymphoma and Leukemia.

    abstract:PURPOSE OF REVIEW:Novel immunotherapies such as checkpoint inhibitors, bispecific antibodies, and chimeric antigen receptor T cells are leading to promising responses when treating solid tumors and hematological malignancies. T cell neoplasms include leukemia and lymphomas that are derived from T cells and overall are ...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-018-0480-8

    authors: Ghione P,Moskowitz AJ,De Paola NEK,Horwitz SM,Ruella M

    更新日期:2018-12-01 00:00:00

  • Brentuximab Vedotin in the Treatment of Peripheral T Cell Lymphoma and Cutaneous T Cell Lymphoma.

    abstract:PURPOSE OF REVIEW:The recent development of brentuximab vedotin (BV), an antibody-drug conjugate targeting CD30-positive cells, has led to therapeutic advances in the treatment of T cell lymphomas. In this review, we discuss key studies of BV in peripheral T cell lymphoma (PTCL) and cutaneous T cell lymphoma (CTCL) and...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-020-00561-w

    authors: Shea L,Mehta-Shah N

    更新日期:2020-02-01 00:00:00

  • Genetic basis of MPN: Beyond JAK2-V617F.

    abstract::The clonal blood disorders polycythemia vera, essential thrombocythemia and primary myelofibrosis belong to the BCR-ABL1-negative myeloproliferative neoplasms and are specified by increased production of terminally differentiated myeloid cells. Clonal evolution, disease initiation and progression are influenced by gen...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-013-0184-z

    authors: Them NC,Kralovics R

    更新日期:2013-12-01 00:00:00

  • The Effect of Psychosocial Interventions on Outcomes for Caregivers of Hematopoietic Cell Transplant Patients.

    abstract:PURPOSE OF REVIEW:Hematopoietic cell transplant (HCT) patients are required to have a caregiver present for up to 100 days post-transplant. Caregivers provide essential support during HCT but experience immense stress and burden. Increasing research has developed interventions for HCT caregivers. This review systematic...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-018-0445-y

    authors: Bangerter LR,Griffin JM,Langer S,Hasan B,Kim WS,Murad MH,Khera N

    更新日期:2018-06-01 00:00:00

  • The Next Generation of JAK Inhibitors: an Update on Fedratinib, Momelotonib, and Pacritinib.

    abstract:PURPOSE OF REVIEW:Ruxolitinib is the first FDA-approved JAK inhibitor for the treatment of myeloproliferative neoplasms and is an effective means of controlling symptom burden and improving splenomegaly. However, a majority of patients will develop disease progression with long-term use. Fedratinib, momelotinib, and pa...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-020-00596-z

    authors: Patel AA,Odenike O

    更新日期:2020-12-01 00:00:00

  • Chemotherapy for patients with acute myeloid leukemia in first remission.

    abstract::Although the majority of patients with acute myeloid leukemia (AML) achieve a complete remission with induction chemotherapy, most will ultimately relapse. Therefore, the optimal postremission therapy for AML remains to be defined, and further improvements in treatment strategies are required. Clinical trials have dem...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-006-0021-8

    authors: Bradstock K

    更新日期:2006-06-01 00:00:00

  • Antibody therapy for acute lymphoblastic leukemia.

    abstract::Advances in chemotherapy administration have made acute lymphoblastic leukemia (ALL) a curable disease; however, most patients will relapse, despite readily attaining a complete remission. Treatment of relapse has shown dismal results with little advances made in the recent decades. Antigenic-directed therapy of ALL c...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-012-0120-7

    authors: Portell CA,Advani AS

    更新日期:2012-06-01 00:00:00

  • Immunotherapy for Multiple Myeloma, Past, Present, and Future: Monoclonal Antibodies, Vaccines, and Cellular Therapies.

    abstract::Multiple myeloma is a disorder of terminally differentiated plasma cells, characterized by immune dysfunction, deregulated signaling within the bone marrow stromal compartment, and a microenvironment that fosters immunosuppression. Immunomodulatory techniques, such as allogeneic hematopoietic stem cell transplant (all...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-015-0283-0

    authors: Karp Leaf R,Cho HJ,Avigan D

    更新日期:2015-12-01 00:00:00

  • A New Target for Hodgkin Lymphoma - Camidanlumab Tesirine.

    abstract:PURPOSE OF REVIEW:There are limited treatment options for relapsed/refractory classical Hodgkin lymphoma (cHL) patients who progress on brentuximab vedotin and programmed death-1 inhibitors. Camidanlumab Tesirine (Cami) is a new agent that has shown activity in multiply relapsed/refractory cHL patients. In this review,...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-021-00604-w

    authors: Epperla N,Hamadani M

    更新日期:2021-01-25 00:00:00

  • High-risk myelodysplastic syndromes: chemotherapy, transplantation, and beyond.

    abstract::Allogeneic hematopoietic cell transplantation (HCT) has curative potential for patients with myelodysplastic syndromes (MDS), though with considerable nonrelapse mortality and morbidity. The International Prognostic Scoring System, despite its confines, remains a widely used tool guiding treatment decisions in MDS. Th...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-009-0035-0

    authors: Gergis U,Wissa U

    更新日期:2010-01-01 00:00:00

  • The role of parenteral nutrition in acute leukemia.

    abstract::Patients with acute leukemia who undergo hematopoietic stem cell transplantation (HSCT) are susceptible to malnutrition caused by several factors including intensive cytotoxic therapy. This paper discusses the significance of malnutrition in these patients and provides an overview of nutrition therapy by the oral, ent...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-996-0007-6

    authors: Jacobson NB,Parekh N,Kalaycio M

    更新日期:2006-09-01 00:00:00

  • The Future of Targeting FLT3 Activation in AML.

    abstract::Internal tandem duplications (ITD) and tyrosine-kinase domain (TKD) mutations of the FMS-like tyrosine-kinase 3 (FLT3) can be found in up to one third of patients with acute myeloid leukemia (AML) and confer a poor prognosis. First discovered 20 years ago, these mutations were identified as viable therapeutic targets,...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-017-0381-2

    authors: Leick MB,Levis MJ

    更新日期:2017-06-01 00:00:00

  • Rituximab maintenance versus radioimmunotherapy consolidation in follicular lymphoma: which, when, and for whom?

    abstract::Follicular lymphoma (FL), the most common indolent lymphoma, typically presents in advanced-stage disease. Currently available therapy does not generally result in a curative outcome, but survival in FL has improved since the introduction of anti-CD20 monoclonal antibody immunotherapy. The goals of treatment include p...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-011-0099-5

    authors: Forstpointner R,Dreyling M

    更新日期:2011-12-01 00:00:00

  • Navigating Ethical Practices in the Era of High Cost Hematology.

    abstract:PURPOSE OF REVIEW:In this review article, we will highlight ethical issues faced by hematologists due to a growing constellation of expensive diagnostics and therapeutics in hematology. We outline the important issues surrounding this topic including stakeholders, cost considerations, and various ethical challenges sur...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-020-00599-w

    authors: Ertz-Archambault N,Khera N

    更新日期:2020-10-01 00:00:00

  • The Management of Lymphoma in the Setting of Pregnancy.

    abstract::The diagnosis of lymphoma in pregnant patients poses a therapeutic challenge necessitating consideration of the developing fetus without compromise of therapy with curative potential for the mother. The decision to initiate therapy during pregnancy is heavily influenced by fetal, maternal, and disease-related factors,...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-017-0386-x

    authors: Pinnix CC,Andraos TY,Milgrom S,Fanale MA

    更新日期:2017-06-01 00:00:00

  • Correction to: Strategies for Predicting Response to Checkpoint Inhibitors.

    abstract::The original version of this article unfortunately contained a mistake. The conflict of interest statement was incorrect. The corrected statement is given below. ...

    journal_title:Current hematologic malignancy reports

    pub_type: 已发布勘误

    doi:10.1007/s11899-018-0488-0

    authors: Zappasodi R,Wolchok JD,Merghoub T

    更新日期:2019-02-01 00:00:00

  • Cutaneous T cell Lymphoma: an Update on Pathogenesis and Systemic Therapy.

    abstract::Mycosis fungoides (MF) and its leukemic variant, Sézary syndrome (SS), are malignancies of skin-homing T cells that comprise the majority of cutaneous T cell lymphomas (CTCL). Treatment of CTCL is limited and can be approached by skin-directed therapy or systemic therapy. Recent investigations into the pathogenesis of...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-015-0293-y

    authors: Chung CG,Poligone B

    更新日期:2015-12-01 00:00:00

  • Infant acute lymphoblastic leukemia: Lessons learned and future directions.

    abstract::Compared with acute lymphoblastic leukemia (ALL) in older children, ALL in infants has a dismal outcome because rearrangements of the mixed-lineage leukemia (MLL) gene occur in about 80% of these patients, leading to an aggressive type of leukemia. With most recent therapies, about 50% long-term event-free survival is...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-009-0023-4

    authors: Pieters R

    更新日期:2009-07-01 00:00:00

  • Who Should Receive a Transplant for Acute Lymphoblastic Leukaemia?

    abstract::Allogeneic haematopoietic cell transplantation continues to be an important curative therapy for acute lymphoblastic leukaemia (ALL). Traditionally accepted indications for allografting adult ALL patients need reevaluation in light of outcomes with paediatric-like intensive regimens. Minimal residual disease status an...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-017-0371-4

    authors: Dhawan R,Marks DI

    更新日期:2017-04-01 00:00:00

  • Treatment of immunoglobulin light chain amyloidosis.

    abstract::No therapy is uniformly effective in the management of immunoglobulin light chain amyloidosis (AL amyloidosis). Despite the common generalization, therapy is highly effective. Options available to patients with AL amyloidosis include high-dose therapy, but this is applicable to only about one fourth of patients. Thera...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-009-0013-6

    authors: Gertz MA,Zeldenrust SR

    更新日期:2009-04-01 00:00:00

  • Twitter Use in the Hematopoietic Cell Transplantation Community.

    abstract:PURPOSE OF REVIEW:Social media has revolutionized the access and exchange of information in healthcare. The microblogging platform Twitter has been used by blood and marrow transplant physicians over the last several years with increasing enthusiasm. We review the adoption of Twitter in the transplant community and its...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-018-0434-1

    authors: Patel SS,Majhail NS

    更新日期:2018-02-01 00:00:00

  • Blastic Plasmacytoid Dendritic Cell Neoplasm.

    abstract:PURPOSE OF REVIEW:Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare malignancy derived from plasmacyoid dendritic cells whose biology, clinical features, and treatment options are increasingly better understood. RECENT FINDINGS:TCF4 is a master regulator that drives donwstream transcriptional programs in ...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-018-0489-z

    authors: Khoury JD

    更新日期:2018-12-01 00:00:00

  • Artificial Intelligence in Hematology: Current Challenges and Opportunities.

    abstract:PURPOSE OF REVIEW:Artificial intelligence (AI), and in particular its subcategory machine learning, is finding an increasing number of applications in medicine, driven in large part by an abundance of data and powerful, accessible tools that have made AI accessible to a larger circle of investigators. RECENT FINDINGS:...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-020-00575-4

    authors: Radakovich N,Nagy M,Nazha A

    更新日期:2020-06-01 00:00:00

  • Dysplasia has A differential diagnosis: distinguishing genuine myelodysplastic syndromes (MDS) from mimics, imitators, copycats and impostors.

    abstract::Just as a pawnshop owner who is unable to distinguish a genuine Rolex™ watch from a cheap knockoff courts financial ruin, the physician who fails to discriminate between authentic myelodysplastic syndromes (MDS) and conditions resembling MDS risks misinforming or harming patients. This review summarizes minimal criter...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-012-0140-3

    authors: Steensma DP

    更新日期:2012-12-01 00:00:00

  • Current Approaches to Transplantation for FLT3-ITD AML.

    abstract:PURPOSE OF REVIEW:This review discusses the current standard of care for incorporation of FLT3 TKIs and HCT into the treatment of FLT3-ITD AML. Additionally, this review provides an approach to the patient with relapsed/refractory disease. RECENT FINDINGS:Over the last decade, the routine use of HCT as consolidative t...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-020-00558-5

    authors: Hunter BD,Chen YB

    更新日期:2020-02-01 00:00:00

  • PET in T-Cell Lymphoma.

    abstract::Most non-Hodgkin lymphomas (NHL) are of B-cell origin; only about 10% are T-cell or NK-cell lymphomas. The clinical features of T/NK-cell lymphomas differ from those of B-cell lymphomas: advanced stage and extranodal disease are more common and the prognosis is worse. Several studies have confirmed that 2-[fluorine-18...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章

    doi:10.1007/s11899-011-0098-6

    authors: Zinzani PL

    更新日期:2011-12-01 00:00:00

  • Perspective on the role of haploidentical transplantation in the management of hematologic malignancies: why do it?

    abstract::Haploidentical hematopoietic stem cell transplantation (HSCT) using mismatched family member donors has historically been complicated by high rates of nonrelapse toxicity and the need for laboratory expertise in depleting grafts of T lymphocytes. Over the past decade, improvements in supportive care, the increased use...

    journal_title:Current hematologic malignancy reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11899-007-0027-x

    authors: Hale GA

    更新日期:2007-07-01 00:00:00