1
|
Niscola P, Gianfelici V, Giovannini M, Piccioni D, Mazzone C, de Fabritiis P. Latest Insights and Therapeutic Advances in Myelodysplastic Neoplasms. Cancers (Basel) 2024; 16:1563. [PMID: 38672645 PMCID: PMC11048617 DOI: 10.3390/cancers16081563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Myelodysplastic syndromes/neoplasms (MDSs) encompass a range of hematopoietic malignancies, commonly affecting elderly individuals. Molecular alterations in the hematopoietic stem cell compartment drive disease pathogenesis. Recent advancements in genomic profiling have provided valuable insights into the biological underpinnings of MDSs and have expanded therapeutic options, particularly for specific molecularly defined subgroups. This review highlights the diagnostic principles, classification updates, prognostic stratification systems, and novel treatments, which could inform future clinical trials and enhance the management of adult MDS patients, particularly for specific molecularly defined subgroups.
Collapse
Affiliation(s)
- Pasquale Niscola
- Division of Haematology, Sant’ Eugenio Hospital, 00144 Rome, Italy; (V.G.); (M.G.); (D.P.); (C.M.); (P.d.F.)
| | | | | | | | | | | |
Collapse
|
2
|
Mo A, Weinkove R, Wood EM, Shortt J, Johnston A, McQuilten ZK. Use of platelet transfusions and tranexamic acid in patients with myelodysplastic syndromes: A clinical practice survey. Eur J Haematol 2024; 112:621-626. [PMID: 38123137 DOI: 10.1111/ejh.14156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
AIM Thrombocytopenia and bleeding are common in myelodysplastic syndromes (MDS), but optimal management is unknown. We conducted a survey to identify current clinical practice regarding platelet transfusion (PLT-T) and tranexamic acid (TXA) to inform future trial design. METHOD A 25-question survey was distributed to members of the ALLG from December 2020 to July 2021. RESULTS Sixty-four clinicians across Australia, New Zealand and Singapore responded. Clinicians treated a median of 15 MDS patients annually. Twenty-nine (45%) reported having institutional guidelines regarding prophylactic PLT-T. Although 60 (94%) said they would consider using TXA, most (58/64; 91%) did not have institutional guidelines. Clinical scenarios showed prophylactic PLT-T was more likely administered for patients on disease-modifying therapy (49/64; 76%, commonest threshold <10 × 109 /L) or with minor bleeding (32/64 [50%] transfusing at threshold <20 × 109 /L, 23/64 [35%] at <10 × 109 /L). For stable untreated patients, 29/64 (45%) would not give PLT-T and 32/64 (50%) would. Most respondents (46/64; 72%) were interested in participating in trials in this area. Potential barriers included resource limitations, funding and patient/clinician acceptance. CONCLUSION Real-world management of MDS-related thrombocytopenia varies and there is a need for clinical trials to inform practice.
Collapse
Affiliation(s)
- Allison Mo
- Australasian Leukaemia & Lymphoma Group (ALLG), Richmond, Victoria, Australia
- Transfusion Research Unit, Monash University, Melbourne, Victoria, Australia
- Monash Haematology, Monash Health, Clayton, Victoria, Australia
- Department of Haematology and Austin Pathology, Austin Health, Heidelberg, Victoria, Australia
| | - Robert Weinkove
- Australasian Leukaemia & Lymphoma Group (ALLG), Richmond, Victoria, Australia
- Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Newtown, New Zealand
- Te Rerenga Ora Wellington Blood & Cancer Centre, Te Whatu Ora Health New Zealand Capital Coast & Hutt Valley, Wellington, New Zealand
| | - Erica M Wood
- Australasian Leukaemia & Lymphoma Group (ALLG), Richmond, Victoria, Australia
- Transfusion Research Unit, Monash University, Melbourne, Victoria, Australia
- Monash Haematology, Monash Health, Clayton, Victoria, Australia
| | - Jake Shortt
- Australasian Leukaemia & Lymphoma Group (ALLG), Richmond, Victoria, Australia
- Monash Haematology, Monash Health, Clayton, Victoria, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Anna Johnston
- Australasian Leukaemia & Lymphoma Group (ALLG), Richmond, Victoria, Australia
- Department of Clinical Haematology, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Zoe K McQuilten
- Australasian Leukaemia & Lymphoma Group (ALLG), Richmond, Victoria, Australia
- Transfusion Research Unit, Monash University, Melbourne, Victoria, Australia
- Monash Haematology, Monash Health, Clayton, Victoria, Australia
| |
Collapse
|