Diagnosis and treatment of primary myelodysplastic syndromes in adults: Recommendations from the European LeukemiaNet

Luca Malcovati, Eva Hellström-Lindberg, David Bowen, Lionel Adès, Jaroslav Cermak, Consuelo Del Cañizo, Matteo G. Della Porta, Pierre Fenaux, Norbert Gattermann, Ulrich Germing, Joop H. Jansen, Moshe Mittelman, Ghulam Mufti, Uwe Platzbecker, Guillermo F. Sanz, Dominik Selleslag, Mette Skov-Holm, Reinhard Stauder, Argiris Symeonidis, Arjan A. Van De LoosdrechtTheo De Witte, Mario Cazzola

Research output: Contribution to journalArticlepeer-review

Abstract

Within the myelodysplastic syndrome (MDS) work package of the European LeukemiaNet, an Expert Panel was selected according to the framework elements of the National Institutes of Health Consensus Development Program. A systematic review of the literature was performed that included indexed original papers, indexed reviews and educational papers, and abstracts of conference proceedings. Guidelines were developed on the basis of a list of patient- and therapy-oriented questions, and recommendations were formulated and ranked according to the supporting level of evidence. MDSs should be classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires the evaluation of not only disease-related factors but also of those related to extrahematologic comorbidity. The assessment of individual risk enables the identification of fit patients withapoor prognosis who are candidates for up-front intensive treatments, primarily allogeneic stem cell transplantation. A high proportion of MDS patients are not eligible for potentially curative treatment becauseofadvanced age and/or clinically relevant comorbidities and poor performance status. In these patients, the therapeutic intervention is aimed at preventing cytopenia-related morbidity and preserving quality of life. A number of new agents are being developed for which the available evidence is not sufficient to recommend routine use. The inclusion of patients into prospective clinical trials is strongly recommended.

Original languageEnglish
Pages (from-to)2943-2964
Number of pages22
JournalBlood
Volume122
Issue number17
DOIs
Publication statusPublished - Oct 24 2013

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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