Articles related to MYELODYSPLASTIC SYNDROMES

Hematologist-oncologists, hematology-oncology NP/PAs, hematology-oncology nurses, and pharmacists should be better able to use criteria for erythroid-stimulating agent (ESA) failure to hasten the identification of patients with lower-risk myelodysplastic syndrome (MDS) refractory to ESA therapy, integrate safety and efficacy data on emerging therapeutic options into treatment planning for patients with lower-risk MDS after ESA failure, and integrate a multidisciplinary treatment approach after taking part in this CME activity.

In this video-supported CME activity, an expert faculty panel will provide their perspectives and insights on the latest trends and emerging research in low-risk MDS, including guideline-directed diagnostic workup, RS evaluation and SF3B1 testing and their implications, currently approved and novel emerging treatment strategies for managing lower risk MDS, and strategies to mitigate and manage treatment-related adverse events.

In this “Letters to Blood,” the author demonstrated that luspatercept provided prolonged periods of transfusion independence (TI), significantly decreased the transfusion burden among HTB and LTB patients, and generally had an acceptable and predictable safety profile, all of which helped to maintain or enhance patient quality of life. Compared to the results from the primary analysis, these data further demonstrate the clinical benefits of luspatercept in patients with LR-MDS-RS.

Even after allogeneic hematopoietic stem-cell transplant (HCT), poor outcomes are typically the case in patients with TP53-mutant (mTP53) acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). The data from recent trials using the combination of eprenetapopt (APR-246) and azacitidine showed positive preclinical results in mTP53 AML/MDS, and this trial sought to assess the efficacy and safety of the eprenetapopt and azacitidine combination as maintenance therapy after allogeneic HCT in patients with mTP53 AML or MDS.

In an integrated analysis of mutations and clinical outcomes, comprising 2,200 patients with TP53-mutated myelodysplastic syndrome (MDS) with excess blasts (EB) or TP53-mutated acute myeloid leukemia (AML), the authors state that mutant TP53 AML and MDS-EB “do not differ with respect to molecular characteristics and survival” and argue these entities should be considered a single molecular disease entity. In a commentary to the above paper, TP53 and the star-crossed lovers MDS and AML, John Welch, MD, PhD of Washington University School of Medicine writes, “As a junior Hematology/Oncology fellow, I was told there were two types of physicians: splitters and mergers. That is, clinicians either seek to diagnose increasingly homogenously narrow groups of patients based on increasingly refined, shared characteristics, or they seek to find broad, overarching patterns that unite diagnostic classifications. Hematologic malignancies have been fertile ground for the diagnostic splitters of the world. On the other hand, there have been some noteworthy exceptions. Sometimes it is a technological advance that allows for the synthesis of disparate diagnoses.”

The authors analyzed the outcome of 349 patients with primary or secondary myelofibrosis undergoing reduced intensity transplantation, of whom 35 had accelerated-phase myelofibrosis. After a median follow-up of 5.9 years, estimated 5-year overall survival was between the two groups, and median overall survival was not reached. In terms of relapse, five-year incidence was 30% for the accelerated-phase group versus 15% for the chronic-phase group. Reduced intensity transplantation showed excellent survival but higher relapse for accelerated-phase myelofibrosis.