Bone Marrow Transplantation (BMT) in Myelodysplastic Syndromes: To BMT or Not to BMT—That Is the Question
Ces deux études analysent respectivement le rôle d'une greffe allogénique de cellules souches hématopoïétiques avec conditionnement atténué dans le traitement de syndromes myélodysplasiques chez les patients âgés ainsi que la performance du système de score révisé IPSS pour prédire la survie des patients et l'évolution de la maladie vers une leucémie
Those who treat patients with myelodysplastic syndromes (MDS) have been forced to become comfortable with a rather uncomfortable truth. MDS is a bone marrow failure syndrome that represents the most commonly diagnosed myeloid malignancy and predominantly affects older adults, with a median age at diagnosis of 71 years. The only cure for MDS is hematopoietic stem-cell transplantation (HSCT). For a variety of reasons, including patient comorbidities, availability of related or matched donors, related donor comorbidities, physician and patient preference, and treatment-related adverse events, transplantation is only considered in approximately 5% of patients with MDS. Thus, even when
we offer disease-modifying therapies such as azacitidine, decitabine, and lenalidomide, we are ultimately palliating 95% of our patients. Despite this, patients often perceive these drugs to have curative potential in this setting, but cure is unfortunately not possible with these agents.
Journal of Clinical Oncology , éditorial en libre accès, 2013