Journal
BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY
Volume 26, Issue 4, Pages 421-429Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.beha.2013.09.008
Keywords
allogeneic hematopoietic stem cell transplantation; hypomethylating agents
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Funding
- Medical Research Council [MR/J006742/1] Funding Source: Medline
- Medical Research Council [MR/J006742/1] Funding Source: researchfish
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Allogeneic hematopoietic stem cell transplantation (allo-HCT) can cure a proportion of patients with myelodysplastic syndromes (MDS). However, MDS remains a disease of the elderly often being not eligible for intensive treatment approaches like allo-HCT. Further, recent new developments with innovative drugs including hypomethylating agents (HMA) have extended the therapeutic alternatives for our patients. Nevertheless, with the introduction of reduced-intensity conditioning and thereby reducing early mortality, transplant numbers in MDS patients have significantly increased recently. Notably, causes of late morbidity and mortality including graft versus host disease and relapse remain and challenge patient care. In the absence of prospective randomized trials emphasis should be put on patient selection and optimization of the pre- and post-transplant treatment in order to achieve long-term disease control and at the same time maintain an adequate quality of life. (C) 2013 Elsevier Ltd. All rights reserved.
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