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

Luca Malcovati; Eva Hellstrom-Lindberg; David Bowen; Lionel Ades; Jaroslav Cermak; Consuelo del Canizo; 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 Loosdrecht; Theo de Witte; Mario Cazzola

doi:10.1182/blood-2013-03-492884

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

Luca Malcovati, Eva Hellstrom-Lindberg, David Bowen, Lionel Ades, Jaroslav Cermak, Consuelo del Canizo, 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^*

^*Corresponding author for this work

Research output: Contribution to journal › Literature review › peer-review

571 Citations (Scopus)

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 with a poor 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 because of advanced 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 language	English
Pages (from-to)	2943-2964
Number of pages	22
Journal	Blood
Volume	122
Issue number	17
DOIs	https://doi.org/10.1182/blood-2013-03-492884
Publication status	Published - 24 Oct 2013

Keywords

ACUTE MYELOID-LEUKEMIA
STEM-CELL TRANSPLANTATION
COLONY-STIMULATING FACTOR
PROGNOSTIC SCORING SYSTEM
BONE-MARROW-TRANSPLANTATION
QUALITY-OF-LIFE
TRANSFUSION-DEPENDENT PATIENTS
DOSE CYTOSINE-ARABINOSIDE
RECOMBINANT-HUMAN-ERYTHROPOIETIN
INTERNATIONAL WORKING GROUP

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Malcovati, L., Hellstrom-Lindberg, E., Bowen, D., Ades, L., Cermak, J., del Canizo, C., Della Porta, M. G., Fenaux, P., Gattermann, N., Germing, U., Jansen, J. H., Mittelman, M., Mufti, G., Platzbecker, U., Sanz, G. F., Selleslag, D., Skov-Holm, M., Stauder, R., Symeonidis, A., ... Cazzola, M. (2013). Diagnosis and treatment of primary myelodysplastic syndromes in adults: recommendations from the European LeukemiaNet. Blood, 122(17), 2943-2964. https://doi.org/10.1182/blood-2013-03-492884

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title = "Diagnosis and treatment of primary myelodysplastic syndromes in adults: recommendations from the European LeukemiaNet",

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 with a poor 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 because of advanced 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.",

keywords = "ACUTE MYELOID-LEUKEMIA, STEM-CELL TRANSPLANTATION, COLONY-STIMULATING FACTOR, PROGNOSTIC SCORING SYSTEM, BONE-MARROW-TRANSPLANTATION, QUALITY-OF-LIFE, TRANSFUSION-DEPENDENT PATIENTS, DOSE CYTOSINE-ARABINOSIDE, RECOMBINANT-HUMAN-ERYTHROPOIETIN, INTERNATIONAL WORKING GROUP",

author = "Luca Malcovati and Eva Hellstrom-Lindberg and David Bowen and Lionel Ades and Jaroslav Cermak and {del Canizo}, Consuelo and {Della Porta}, {Matteo G.} and Pierre Fenaux and Norbert Gattermann and Ulrich Germing and Jansen, {Joop H.} and Moshe Mittelman and Ghulam Mufti and Uwe Platzbecker and Sanz, {Guillermo F.} and Dominik Selleslag and Mette Skov-Holm and Reinhard Stauder and Argiris Symeonidis and {van de Loosdrecht}, {Arjan A.} and {de Witte}, Theo and Mario Cazzola",

year = "2013",

month = oct,

day = "24",

doi = "10.1182/blood-2013-03-492884",

language = "English",

volume = "122",

pages = "2943--2964",

journal = "Blood",

issn = "0006-4971",

publisher = "American Society of Hematology",

number = "17",

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Malcovati, L, Hellstrom-Lindberg, E, Bowen, D, Ades, L, Cermak, J, del Canizo, C, Della Porta, MG, Fenaux, P, Gattermann, N, Germing, U, Jansen, JH, Mittelman, M, Mufti, G, Platzbecker, U, Sanz, GF, Selleslag, D, Skov-Holm, M, Stauder, R, Symeonidis, A, van de Loosdrecht, AA, de Witte, T & Cazzola, M 2013, 'Diagnosis and treatment of primary myelodysplastic syndromes in adults: recommendations from the European LeukemiaNet', Blood, vol. 122, no. 17, pp. 2943-2964. https://doi.org/10.1182/blood-2013-03-492884

TY - JOUR

T1 - Diagnosis and treatment of primary myelodysplastic syndromes in adults

T2 - recommendations from the European LeukemiaNet

AU - Malcovati, Luca

AU - Hellstrom-Lindberg, Eva

AU - Bowen, David

AU - Ades, Lionel

AU - Cermak, Jaroslav

AU - del Canizo, Consuelo

AU - Della Porta, Matteo G.

AU - Fenaux, Pierre

AU - Gattermann, Norbert

AU - Germing, Ulrich

AU - Jansen, Joop H.

AU - Mittelman, Moshe

AU - Mufti, Ghulam

AU - Platzbecker, Uwe

AU - Sanz, Guillermo F.

AU - Selleslag, Dominik

AU - Skov-Holm, Mette

AU - Stauder, Reinhard

AU - Symeonidis, Argiris

AU - van de Loosdrecht, Arjan A.

AU - de Witte, Theo

AU - Cazzola, Mario

PY - 2013/10/24

Y1 - 2013/10/24

N2 - 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 with a poor 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 because of advanced 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.

AB - 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 with a poor 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 because of advanced 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.

KW - ACUTE MYELOID-LEUKEMIA

KW - STEM-CELL TRANSPLANTATION

KW - COLONY-STIMULATING FACTOR

KW - PROGNOSTIC SCORING SYSTEM

KW - BONE-MARROW-TRANSPLANTATION

KW - QUALITY-OF-LIFE

KW - TRANSFUSION-DEPENDENT PATIENTS

KW - DOSE CYTOSINE-ARABINOSIDE

KW - RECOMBINANT-HUMAN-ERYTHROPOIETIN

KW - INTERNATIONAL WORKING GROUP

U2 - 10.1182/blood-2013-03-492884

DO - 10.1182/blood-2013-03-492884

M3 - Literature review

SN - 0006-4971

VL - 122

SP - 2943

EP - 2964

JO - Blood

JF - Blood

IS - 17

ER -

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

Abstract

Keywords

UN SDGs

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