Abstract：
:Advances in therapy can essentially be measured using two parameters; introduction of a new agent which benefits an increased number of patients over prevailing treatments or more selective use of an existing drug by matching it to the biologic characteristics associated with response. In reviewing the therapeutic landscape of myelodysplastic syndromes (MDS), both should be applied to gauge the advances in therapy. While several new drugs are currently in clinical trials for the treatment of MDS, three drugs were approved for use in the last decade and sufficient time has elapsed to take stock of the benefit they have produced in the outcome of patients both in terms of survival and quality of life. For the two hypomethylating agents, response remains limited to 50% patients at best, and no strategy has evolved to allow for pre-selection of likely responders, however, 5-azacytidine has been associated with improvement in the survival of higher risk patients. The benefit of lenalidomide was found to be greater for del(5q) patients with transfusion dependent anemia and lower risk disease right from the start, although a quarter of the non-del(5q) patients also experienced complete transfusion independence with this agent. It is in this latter group of non-del(5q) cases that a strategy for potentially preselecting likely responders is suggested by the finding of an expression profile associated with response. In this paper, we will focus on defining our current understanding of the mechanisms of action of the existing FDA approved drugs in order to identify therapeutic strategies that are suitable for specific MDS subtypes. We expect that through advancing biologic insights, the use of such therapies will become more selective and refined.
journal_name
Blood Revjournal_title
Blood reviewsauthors
Schecter J,Galili N,Raza Adoi
10.1016/j.blre.2011.11.001subject
Has Abstractpub_date
2012-03-01 00:00:00pages
73-80issue
2eissn
0268-960Xissn
1532-1681pii
S0268-960X(11)00081-6journal_volume
26pub_type
杂志文章,评审相关文献
BLOOD REVIEWS文献大全abstract：:Extramedullary disease of multiple myeloma (EM) remains a treatment challenge even in the era of new drugs. While many reports analyzing various aspects of EM have been published, mechanism of EM development has not been clarified yet. This review summarizes current knowledge about this clinical entity, including its ...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2019.04.002
更新日期：2019-07-01 00:00:00
abstract：:Myeloid neoplasms like acute myeloid leukemia (AML) originate from genomic disruption, usually in a multi-step fashion. Hematopoietic stem/progenitor cell acquisition of abnormalities in vital cellular processes, when coupled with intrinsic factors such as germline predisposition or extrinsic factors such as the marro...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2020.100760
更新日期：2020-09-22 00:00:00
abstract：:Immune checkpoint inhibitors (ICI) have yielded mixed but largely underwhelming results in clinical trials in patients with acute myeloid leukemia and myelodysplastic syndromes to date. However, increasing understanding of the immunologic landscape, potential biomarkers for benefits, and mechanisms of resistance, as w...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2020.100709
更新日期：2020-05-23 00:00:00
abstract：:Childhood immune thrombocytopenic purpura (ITP) is acute and generally seasonal in nature, suggesting that infectious or environmental agents may trigger the immune response to produce platelet-reactive autoantibodies 4 to 8 weeks following an infection. In general, the patient is well apart from the diffuse bruising ...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1054/blre.2001.0177
更新日期：2002-03-01 00:00:00
abstract：:Uncontrolled bleeding is the most common preventable cause of death for patients with severe injury. Coagulopathy inevitably accompanies severe bleeding, exacerbated by the ongoing blood loss and the treatments administered. There is debate about the underlying pathophysiological mechanisms of early traumatic coagulop...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2012.06.004
更新日期：2012-09-01 00:00:00
abstract：:Invasive fungal infections are significant causes of morbidity and mortality in patients with hematological malignancies. Patients with acute myeloid leukemia and those who have undergone allogeneic hematopoietic stem cell transplantation are at especially high risk. Various fungal agents are responsible for this comp...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2009.11.003
更新日期：2010-03-01 00:00:00
abstract：:Splenomegaly is a feature of a broad range of diseases, and presents to clinicians in many fields. This review examines the aetiology of splenomegaly in the developed world, and describes a logical approach to the patient with splenomegaly. In some patients, extensive radiological and laboratory investigations will fa...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2008.10.001
更新日期：2009-05-01 00:00:00
abstract：:Most leukemia patients experience little benefit from immunotherapy, in part due to the immunosuppressive bone marrow microenvironment. Various metabolic mechanisms orchestrate the behaviors of immune cells and leukemia cells in the bone marrow microenvironment. Furthermore, leukemia cells regulate the bone marrow mic...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2020.100786
更新日期：2020-12-09 00:00:00
abstract：:This review sets out to synthesize and critically evaluate the current reported data regarding therapeutic options for the neutropenia associated with Felty syndrome (Felty neutropenia). A MEDLINE search and bibliographies from recent reviews were used to identify trials and case reports that provided sufficient data ...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/s0268-960x(96)90024-7
更新日期：1996-09-01 00:00:00
abstract：:The anthracyclines are widely used in the treatment of haematological and non-haematological malignancy and there is now more than 30 years' clinical experience with these agents but despite this, their mechanism of action is incompletely understood. The anthracyclines have been shown to intercalate with DNA and indir...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/s0268-960x(97)90020-5
更新日期：1997-12-01 00:00:00
abstract：:The unstable haemoglobin haemolytic anaemias result from the presence in the red cell of a structurally abnormal haemoglobin variant. There are many mutations producing unstable haemoglobins; most are single amino acid replacements that affect a few key areas of the haemoglobin structure. A wide range of haemoglobin i...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(93)90002-l
更新日期：1993-09-01 00:00:00
abstract：:The inherited haemoglobinopathies are large group of disorders that include the thalassaemias and sickle cell disease. Carrier detection methods must be able to detect alpha-, beta- and deltabeta-thalassaemias, HPFH disorders and haemoglobin variants. Carrier diagnosis involves the accurate measurement of MCH, MCV, Hb...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/s0268-960x(02)00061-9
更新日期：2003-03-01 00:00:00
abstract：:Venous thromboembolism (VTE) remains a major cause of morbidity and mortality in patients with cancer. Although some very well validated scores delineate the risk of VTE by cancer subtype and other risk factors, hematologic malignancies are underrepresented in these models. This subgroup represents a unique entity tha...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2018.06.002
更新日期：2019-01-01 00:00:00
abstract：:Drug-induced agranulocytosis is a highly individualized and unexpected reaction to specific drugs. It may be due to immunogenic or cytotoxic factors. Most instances are produced by a poorly understood immune response to immunogenic drugs. Others are associated with direct suppression of marrow committed stem cells by ...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(90)90002-a
更新日期：1990-12-01 00:00:00
abstract：:In this review, salient molecular, biochemical and functional features of human interleukin 2 (IL-2), its membrane receptor, and its clinical relevance are outlined. We also describe experimental systems, where observed biological or pharmacological effects of IL-2 could be applied to corresponding clinical situations...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(87)90027-0
更新日期：1987-12-01 00:00:00
abstract：:Cytogenetic analyses in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) have revealed a great number of non-random chromosome abnormalities. In many instances, molecular studies of these abnormalities identified specific genes implicated in the process of leukemogenesis. The more common chromosome ...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/S0268-960X(03)00040-7
更新日期：2004-06-01 00:00:00
abstract：:Fears about the risks of disease transmission through the transfusion of homologous blood, as well as problems with blood supply and cost have increased the interest in reducing perioperative bleeding. This article discusses the causes of non-surgical perioperative bleeding and attempts to reduce perioperative bleedin...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(91)90034-a
更新日期：1991-09-01 00:00:00
abstract：:The myelodysplastic syndromes (MDS) are characterized by cytopenias and acute myeloid leukemia risk. Most MDS patients eventually require transfusion of red blood cells for anemia, placing them at risk of iron overload (IOL). In beta-thalassemia major, transfusional IOL leads to organ dysfunction and death, however, w...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2010.09.003
更新日期：2011-01-01 00:00:00
abstract：:DNA analysis has become of practical value in the diagnosis and classification of leukaemias and lymphomas. This is exemplified by the study of lymphoproliferative disorders using immunoglobulin and T-cell receptor gene probes for the determination of clonality and cell lineage. Chromosomal analysis with DNA probes is...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(88)90028-8
更新日期：1988-06-01 00:00:00
abstract：:Methaemoglobinaemia arises from the production of non-functional haemoglobin containing oxidised Fe(3+) which results in reduced oxygen supply to the tissues and manifests as cyanosis in the patient. It can develop by three distinct mechanisms: genetic mutation resulting in the presence of abnormal haemoglobin, a defi...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2004.02.001
更新日期：2005-03-01 00:00:00
abstract：:Platelet transfusions are widely used. Prophylactic transfusions are employed in severely thrombocytopenic patients without evidence of bleeding, but no randomized trial data prove the safety or efficacy of this approach. Randomized trials have demonstrated the equivalence of transfusion triggers of 10,000 and 20,000/...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/S0268-960X(03)00057-2
更新日期：2004-09-01 00:00:00
abstract：:Chronic lymphocytic leukemia (CLL) is a disease of older patients and median age at diagnosis is 72 years. This older group is under-represented in clinical trials, (median age 58-62 years). Here we review background data on incidence, survival, definitions of older age, fitness criteria, frailty and co-morbidities. I...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2011.09.002
更新日期：2012-01-01 00:00:00
abstract：:Thrombopoietin (TPO) is the key cytokine involved in thrombopoiesis, and is the endogenous ligand for the thrombopoietin receptor that is expressed on the surface of platelets, megakaryocytes, and megakaryocytic precursors. First-generation thrombopoietic agents were recombinant forms of human TPO, and their developme...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2010.04.002
更新日期：2010-07-01 00:00:00
abstract：:We are often faced with the question as to the optimum duration of secondary prophylaxis with oral anticoagulants after an episode of venous thromboembolism. Theoretically if we know the recurrence rate, the case-fatality, the effectiveness of oral anticoagulant therapy, and the rate of fatal haemorrhage on treatment,...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2005.09.001
更新日期：2006-05-01 00:00:00
abstract：:The rate of relapse after allogeneic bone marrow transplantation (BMT) varies between 15 and 60%. New therapeutic strategies are required urgently as no significant results have been obtained with standard chemotherapy. The best results of second allogeneic BMT have been obtained when the interval between the first an...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(94)90111-2
更新日期：1994-12-01 00:00:00
abstract：:After many unsuccessful years of searching, the first pathogenic human retrovirus, the human T-cell leukaemia lymphoma virus (HTLV-I), was reported as recently as 1980 and since that time has been causally linked to the adult T-cell leukaemia lymphoma syndrome. A second HTLV (HTLV-II) isolated shortly afterwards is le...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(88)90010-0
更新日期：1988-12-01 00:00:00
abstract：:Extracorporeal phototherapy (ECP) is a therapeutic approach based on the biological effect of psoralen 8-methoxypsoralen (8-MOP) and ultraviolet light A (UVA) on mononuclear cells collected by apheresis, and reinfused into the patient. Photopheresis is widely used for the treatment of patients with advanced cutaneous ...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1054/blre.2001.0155
更新日期：2001-06-01 00:00:00
abstract：:In the vicinity of an acute inflammatory response both cellular and non-cellular elements may interact to modify the overall response. Evidence suggests that leukocytes may play an active role in the modulation of platelet function and vice-versa. This interaction may be abnormal in certain pathological states. Neutro...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/0268-960x(92)90010-n
更新日期：1992-06-01 00:00:00
abstract：:Stimulation with the vasopressin analogue desmopressin (DDAVP) of extrarenal arginine vasopressin (AVP) V2-receptors in endothelial cells and possible in platelets increases the circulating levels of coagulation factor VIII (FVIII), von Willebrand factor (VWF) and tissue plasminogen activator (t-PA). The purpose of th...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/j.blre.2014.03.001
更新日期：2014-05-01 00:00:00
abstract：:The diagnostic approach to easy bruising or a suspected mild bleeding disorder includes a careful history and physical examination as well as laboratory investigations. The history should determine whether or not a bleeding disorder exists and help elucidate possible causes. The physical examination should evaluate ev...
journal_title：Blood reviews
pub_type： 杂志文章,评审
doi：10.1016/s0268-960x(05)80014-1
更新日期：1994-06-01 00:00:00
