In order to facilitate clinical decision on management of patients with myelodysplastic syndromes (MDS), arbitrary terminologies of lower-risk and higher-risk disease are typically utilized. In general, lower-risk disease includes the low and intermediate-1 risk groups under the International Prognostic Scoring System (IPSS), and higher-risk disease encompasses those in the intermediate-2 and high-risk categories. In the revised version of IPSS (IPSS-R), the very low and low-risk groups can be considered under lower-risk disease, high and very high risk groups under high-risk, and the intermediate group would lie between the two. Such stratification, however, is not secure from flaws and deficiencies. Moreover, particular patients may fall into a specific risk group, while they follow a different clinical course. This chapter will provide a review of management strategies for lower-risk MDS. A practical approach to the choice of initial and subsequent therapies will be offered with consideration of type and degree of cytopenia. In addition, specific topics of supportive care, approach to the treatment of MDS/MPN, and the issue of iron overload with frequent transfusions will be elaborated. Finally, relying on data from clinical trials, extensive discussion on therapeutic modalities including growth factors and immunosuppressive therapy will be offered.
|Original language||English (US)|
|Title of host publication||Myelodysplastic Syndromes|
|Subtitle of host publication||From Pathogenesis to Diagnosis and Therapy|
|Publisher||Nova Science Publishers, Inc.|
|Number of pages||20|
|State||Published - Jan 1 2013|
ASJC Scopus subject areas