Less Advanced MDS

The best results with allogeneic HCT are achieved in patients with low myeloblast counts in the marrow, i.e., RA RARS (or RCMD, RCRS), at the time of transplantation, and patients without high-risk clonal cytogenetic abnormalities (less advanced MDS) (Table 12.1). The European Group for Blood and Marrow Transplantation (EBMT) reported on 131 patients, most conditioned with total body irradiation (TBI)-based regimens (70 ) and transplanted from HLA-identical siblings. Five-year RFS was 52 , and...

References

Anderson JE, Appelbaum FR, Schoch G, Gooley T, Anasetti C, Bensinger WI, Bryant E, Buckner CD, Chauncey T, Clift RA, Deeg HJ, Doney K, Flowers M, Hansen JA, Martin PJ, Matthews DC, Nash RA, Sanders JE, Shulman H, Sullivan KM, Witherspoon RP, Storb R (1996) Allogeneic marrow transplantation for myelodysplastic syndrome with advanced disease morphology a phase II study of busulfan, cyclophosphamide, and total-body irradiation and analysis of prognostic factors, J Clin Oncol 14 220-226 Appelbaum...

Evaluating Clinical Trial Data Response Criteria

The acceptance of new interventions into routine management is dependent upon a solid evidence base for its efficacy and safety. The demonstration of efficacy of an interventional agent will be judged by its ability to produce clinical or hematological improvement or both to an extent that is considered clinically meaningful by both physician and patient. The debate surrounding the clinical use of recombinant erythropoietin in the management of MDS is a good example. An International Working...

Ionizing Radiation

MDS cases are reported in cohorts of individuals exposed to radiation, for treatment of diseases such as ankylosing spondylitis Brown and Doll 1965 , or following exposure to the A-bomb in Hiroshima and Nagasaki Matsuo et al. 1988 . Some of these cases occurred up to 40 years after exposure and thus the precise association between the development of MDS and exposure to radiation is impossible to quantify. Mauritzson et al. 2002 also identified a longer latency period for the development of...