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Biology and treatment of myelodysplastic syndromes — developments in the past decade

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  • 22 Citations

Conclusions

During the past 10 years, MDS has become a topic of considerable interest due to the development of new cytogenetic and molecular techniques and the introduction of the clinical administration of hematopoietic growth factors. The cytological and clinical classifications of the diseases comprising the syndrome are based on two main subtypes, those with a low risk of acquiring acute leukemia and those with a high risk. Which one will prove to be the simplest and most reliable classification system for the individual patient is not yet clear.

Studies on clonality have shown that the myeloid cells in most of the patients studied thus far are monoclonal in nature. These methods can be used to evaluate the effect of treatment regimens.

The kinetics of the in vitro growth of hematopoietic precursor cells from MDS patients is abnormal, with suboptimal colony formation. Cultures grown in the presence of certain growth factors show preferential growth of normal hematopoietic cells, which may be of clinical relevance in the future.

Administration to MDS patients of hematopoietic growth factors such as GM-CSF, G-CSF, and IL-3 improves neutrophil counts in the majority of cases. The effect of erythropoietin is disappointing in most cases. At present, polyclonal hematopoiesis is rarely induced by growth factor treatment alone. More recently identified growth factors, such as MGF, might preferentially affect normal hematopoiesis at the expense of the preleukemic clones, thus changing the natural course of the disease.

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Willemze, R., Fibbe, W.E., Falkenburg, J.H.F. et al. Biology and treatment of myelodysplastic syndromes — developments in the past decade. Ann Hematol 66, 107–115 (1993). https://doi.org/10.1007/BF01697618

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Keywords

  • Erythropoietin
  • Colony Formation
  • Myeloid Cell
  • Acute Leukemia
  • Myelodysplastic Syndrome