open access
Vol 53, No 2 (2022)
Guidelines / Expert consensus
Submitted: 2021-10-08
Accepted: 2021-11-25
Published online: 2022-03-07
Get Citation
Treatment recommendations developed by MDS experts of the Polish Adult Leukemia Group (PALG) for management of myelodysplastic syndromes (MDSs) and other MDS-related conditions in Poland for 2021
Krzysztof Mądry1, Bożena Katarzyna Budziszewska2, Karol Lis1, Joanna Drozd-Sokołowska1, Bartłomiej Pogłódek3, Rafał Machowicz1, Edyta Subocz4, Katarzyna Wisniewska-Piąty5, Tomasz Wróbel6, Jan Maciej Zaucha7, Ewa Zarzycka7, Ewa Karakulska-Prystupiuk1, Lidia Gil8, Aleksandra Butrym9, Agnieszka Tomaszewska1, Grzegorz Władysław Basak1, Anna Waszczuk-Gajda1, Agnieszka Pluta10, Paweł Szwedyk11, Małgorzata Jarmuż-Szymczak8, Jagoda Rytel1, Jadwiga Dwilewicz-Trojaczek1
DOI: 10.5603/AHP.a2022.0009
·
Acta Haematol Pol 2022;53(2):75-93.
Affiliations- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Poland
- Department of Hematology, Institute of Hematology and Transfusiology, Warsaw, Poland
- Department of Hematology, Jagiellonian University, Kraków
- Department of Hematology, Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration’s Hospital, Olsztyn
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wrocław Medical University, Wrocław, Poland
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
- Department of Cancer Prevention and Therapy, Wroclaw Medical University, Wroclaw, Poland
- Department of Hematology, Medical University, Lodz, Poland
- Department of Hematology, Ludwik Rydygier Hospital, Krakow, Poland
open access
Vol 53, No 2 (2022)
EXPERT GUIDELINES
Submitted: 2021-10-08
Accepted: 2021-11-25
Published online: 2022-03-07
Abstract
Myelodysplastic syndromes (MDS) comprise a heterogeneous group of malignant hematopoietic stem cell disorders that are characterized by ineffective blood cell production and a variable risk of transformation into acute myeloid leukemia. In recent years, significant progress in MDS biological research has allowed the addition of new drugs to the few existing therapeutic options.
This article presents the recommendations of MDS experts of the Polish Adult Leukemia Group for the treatment of myelodysplastic syndromes, and for the management of conditions that are particularly common in patients with MDS i.e. infections, iron overload, and disease recurrence after hematopoietic cell transplantation. The aim of this study was to present a clear therapeutic algorithm to facilitate decision-making in everyday practice.
Abstract
Myelodysplastic syndromes (MDS) comprise a heterogeneous group of malignant hematopoietic stem cell disorders that are characterized by ineffective blood cell production and a variable risk of transformation into acute myeloid leukemia. In recent years, significant progress in MDS biological research has allowed the addition of new drugs to the few existing therapeutic options.
This article presents the recommendations of MDS experts of the Polish Adult Leukemia Group for the treatment of myelodysplastic syndromes, and for the management of conditions that are particularly common in patients with MDS i.e. infections, iron overload, and disease recurrence after hematopoietic cell transplantation. The aim of this study was to present a clear therapeutic algorithm to facilitate decision-making in everyday practice.
Get Citation
Keywords
myelodysplastic syndromes, treatment, recommendations
About this articleTitle
Treatment recommendations developed by MDS experts of the Polish Adult Leukemia Group (PALG) for management of myelodysplastic syndromes (MDSs) and other MDS-related conditions in Poland for 2021
Journal
Issue
Article type
Guidelines / Expert consensus
Pages
75-93
Published online
2022-03-07
Page views
2018
Article views/downloads
768
DOI
10.5603/AHP.a2022.0009
Bibliographic record
Acta Haematol Pol 2022;53(2):75-93.
Keywords
myelodysplastic syndromes
treatment
recommendations
Authors
Krzysztof Mądry
Bożena Katarzyna Budziszewska
Karol Lis
Joanna Drozd-Sokołowska
Bartłomiej Pogłódek
Rafał Machowicz
Edyta Subocz
Katarzyna Wisniewska-Piąty
Tomasz Wróbel
Jan Maciej Zaucha
Ewa Zarzycka
Ewa Karakulska-Prystupiuk
Lidia Gil
Aleksandra Butrym
Agnieszka Tomaszewska
Grzegorz Władysław Basak
Anna Waszczuk-Gajda
Agnieszka Pluta
Paweł Szwedyk
Małgorzata Jarmuż-Szymczak
Jagoda Rytel
Jadwiga Dwilewicz-Trojaczek
References (124)- Pfeilstöcker M, Tuechler H, Sanz G, et al. Time-dependent changes in mortality and transformation risk in MDS. Blood. 2016; 128(7): 902–910.
- Fenaux P, Haase D, Santini V, et al. ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Myelodysplastic syndromes: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021; 32(2): 142–156.
- Cheson BD, Greenberg PL, Bennett JM, et al. Clinical application and proposal for modification of the International Working Group (IWG) response criteria in myelodysplasia. Blood. 2006; 108(2): 419–425.
- Platzbecker U, Fenaux P, Adès L, et al. Proposals for revised IWG 2018 hematological response criteria in patients with MDS included in clinical trials. Blood. 2019; 133(10): 1020–1030.
- Malcovati L, Della Porta MG, Strupp C, et al. Impact of the degree of anemia on the outcome of patients with myelodysplastic syndrome and its integration into the WHO classification-based Prognostic Scoring System (WPSS). Haematologica. 2011; 96(10): 1433–1440.
- Oliva EN, Schey C, Hutchings AS. A review of anemia as a cardiovascular risk factor in patients with myelodysplastic syndromes. Am J Blood Res. 2011; 1(2): 160–166.
- Stauder R, Yu Ge, Koinig KA, et al. Health-related quality of life in lower-risk MDS patients compared with age- and sex-matched reference populations: a European LeukemiaNet study. Leukemia. 2018; 32(6): 1380–1392.
- Stanworth SJ, Killick S, McQuilten ZK, et al. REDDS Investigators. Red cell transfusion in outpatients with myelodysplastic syndromes: a feasibility and exploratory randomised trial. Br J Haematol. 2020; 189(2): 279–290.
- Sekeres MA, Maciejewski JP, List AF, et al. Perceptions of disease state, treatment outcomes, and prognosis among patients with myelodysplastic syndromes: results from an internet-based survey. Oncologist. 2011; 16(6): 904–911.
- de Swart L, Crouch S, Hoeks M, et al. Impact of red blood cell transfusion dose density on progression-free survival in patients with lower-risk myelodysplastic syndromes. Haematologica. 2020; 105(3): 632–639.
- Carson JL, Grossman BJ, Kleinman S, et al. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2012; 157(1): 49–58.
- Gu Y, Estcourt LJ, Doree C, et al. Comparison of a restrictive versus liberal red cell transfusion policy for patients with myelodysplasia, aplastic anaemia, and other congenital bone marrow failure disorders. Cochrane Database Syst Rev. 2015; 3(CD011577).
- Mo A, McQuilten ZK, Wood EM, et al. Red cell transfusion thresholds in myelodysplastic syndromes: a clinician survey to inform future clinical trials. Intern Med J. 2017; 47(6): 695–698.
- EU MDS Registry. https://nmds org (October 18, 2021).
- Killick SB, Carter C, Culligan D. Guidelines for the diagnosis and management of adult myelodysplastic syndromes. Br J Haematol. 2014; 164(4): 503–525.
- Estcourt LJ, Birchall J, Allard S, et al. Guidelines for the use of platelet transfusions. Br J Haematol. 2017; 176(3): 365–394.
- Schiffer CA, Bohlke K, Delaney M, et al. Platelet transfusion for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2018; 36(3): 283–299.
- Liumbruno G, Bennardello F, Lattanzio A, et al. Recommendations for the transfusion of plasma and platelets. Blood Transfus. 2009; 7(2): 132–150.
- Kaufman RM, Djulbegovic B, Gernsheimer T, et al. Platelet transfusion: a cinical practice guideline from the AABB. Ann Intern Med. 2015; 162(3): 205–213.
- Desborough M, Hadjinicolaou AV, Chaimani A, et al. Alternative agents to prophylactic platelet transfusion for preventing bleeding in people with thrombocytopenia due to chronic bone marrow failure: a meta-analysis and systematic review. Cochrane Database Syst Rev. 2016; 10: CD012055.
- Killick SB, Ingram W, Culligan D, et al. British Society for Haematology guidelines for the management of adult myelodysplastic syndromes. Br J Haematol. 2021; 194(2): 267–281.
- Fenaux P, Santini V, Spiriti MA, et al. A phase 3 randomized, placebo-controlled study assessing the efficacy and safety of epoetin-α in anemic patients with low-risk MDS. Leukemia. 2018; 32(12): 2648–2658.
- Platzbecker U, Symeonidis A, Oliva EN, et al. A phase 3 randomized placebo-controlled trial of darbepoetin alfa in patients with anemia and lower-risk myelodysplastic syndromes. Leukemia. 2017; 31(9): 1944–1950.
- Hellström-Lindberg E, Gulbrandsen N, Lindberg G, et al. Scandinavian MDS Group. A validated decision model for treating the anaemia of myelodysplastic syndromes with erythropoietin + granulocyte colony-stimulating factor: significant effects on quality of life. Br J Haematol. 2003; 120(6): 1037–1046.
- Garelius HKG, Johnston WT, Smith AG, et al. Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome. J Intern Med. 2017; 281(3): 284–299.
- Park S, Kelaidi C, Sapena R, et al. Early introduction of ESA in low risk MDS patients may delay the need for RBC transfusion: a retrospective analysis on 112 patients. Leuk Res. 2010; 34(11): 1430–1436.
- Greenberg PL, Sun Z, Miller KB, et al. Treatment of myelodysplastic syndrome patients with erythropoietin with or without granulocyte colony-stimulating factor: results of a prospective randomized phase 3 trial by the Eastern Cooperative Oncology Group (E1996). Blood. 2009; 114(12): 2393–2400.
- Park S, Greenberg P, Yucel A, et al. Clinical effectiveness and safety of erythropoietin-stimulating agents for the treatment of low- and intermediate-1-risk myelodysplastic syndrome: a systematic literature review. Br J Haematol. 2019; 184(2): 134–160.
- Kelaidi C, Park S, Sapena R, et al. Long-term outcome of anemic lower-risk myelodysplastic syndromes without 5q deletion refractory to or relapsing after erythropoiesis-stimulating agents. Leukemia. 2013; 27(6): 1283–1290.
- Park S, Fenaux P, Greenberg P, et al. Efficacy and safety of darbepoetin alpha in patients with myelodysplastic syndromes: a systematic review and meta-analysis. Br J Haematol. 2016; 174(5): 730–747.
- Giagounidis A, Mufti GJ, Fenaux P, et al. Results of a randomized, double-blind study of romiplostim versus placebo in patients with low/intermediate-1-risk myelodysplastic syndrome and thrombocytopenia. Cancer. 2014; 120(12): 1838–1846.
- Kantarjian H, Fenaux P, Sekeres MA, et al. Safety and efficacy of romiplostim in patients with lower-risk myelodysplastic syndrome and thrombocytopenia. J Clin Oncol. 2010; 28(3): 437–444.
- Sekeres MA, Kantarjian H, Fenaux P, et al. Subcutaneous or intravenous administration of romiplostim in thrombocytopenic patients with lower risk myelodysplastic syndromes. Cancer. 2011; 117(5): 992–1000.
- Oliva EN, Alati C, Santini V, et al. Eltrombopag versus placebo for low-risk myelodysplastic syndromes with thrombocytopenia (EQoL-MDS): phase 1 results of a single-blind, randomised, controlled, phase 2 superiority trial. Lancet Haematol. 2017; 4(3): e127–e136.
- Kantarjian HM, Fenaux P, Sekeres M, et al. Long-term follow-up for up to 5 years on the risk of leukaemic progression in thrombocytopenic patients with lower-risk myelodysplastic syndromes treated with romiplostim or placebo in a randomised double-blind trial. Lancet Haematol. 2018; 5(3): e117–e126.
- Girmenia C, Candoni A, Delia M, et al. Infection control in patients with myelodysplastic syndromes who are candidates for active treatment: Expert panel consensus-based recommendations. Blood Rev. 2019; 34: 16–25.
- Fenaux P, Platzbecker U, Ades L. How we manage adults with myelodysplastic syndrome. Br J Haematol. 2020; 189(6): 1016–1027.
- Hutzschenreuter F, Monsef I, Kreuzer KA, et al. Granulocyte and granulocyte-macrophage colony stimulating factors for newly diagnosed patients with myelodysplastic syndromes. Cochrane Database Syst Rev. 2016; 2: CD009310.
- Greenberg PL, Stone R, Al-Kali A, et al. Myelodysplastic syndromes, version 2.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2016; 15(1): 60–87.
- Fenaux P, Giagounidis A, Selleslag D, et al. MDS-004 Lenalidomide del5q Study Group. A randomized phase 3 study of lenalidomide versus placebo in RBC transfusion-dependent patients with Low-/Intermediate-1-risk myelodysplastic syndromes with del5q. Blood. 2011; 118(14): 3765–3776.
- Giagounidis A, Fenaux P, Mufti GJ, et al. Practical recommendations on the use of lenalidomide in the management of myelodysplastic syndromes. Ann Hematol. 2008; 87(5): 345–352.
- Volpe VO, Komrokji RS. Treatment options for lower-risk myelodysplastic syndromes. Where are we now? Ther Adv Hematol. 2021; 12: 2040620720986641.
- Santini V, Almeida A, Giagounidis A, et al. Randomized phase III study of lenalidomide versus placebo in RBC transfusion-dependent patients with lower-risk non-del(5q) myelodysplastic syndromes and ineligible for or refractory to erythropoiesis-stimulating agents. J Clin Oncol. 2016; 34(25): 2988–2996.
- Toma A, Kosmider O, Chevret S, et al. Lenalidomide with or without erythropoietin in transfusion-dependent erythropoiesis-stimulating agent-refractory lower-risk MDS without 5q deletion. Leukemia. 2015; 30(4): 897–905.
- Fenaux P, Platzbecker U, Mufti GJ, et al. Luspatercept in patients with lower-risk myelodysplastic syndromes. N Engl J Med. 2020; 382(2): 140–151.
- Radsak M, Platzbecker U, Schmidt CS, et al. Infectious complications in patients with myelodysplastic syndromes: a review of the literature with emphasis on patients treated with 5-azacitidine. Eur J Haematol. 2017; 99(2): 112–118.
- Sloand EM, Olnes MJ, Shenoy A, et al. Alemtuzumab treatment of intermediate-1 myelodysplasia patients is associated with sustained improvement in blood counts and cytogenetic remissions. J Clin Oncol. 2010; 28(35): 5166–5173.
- Stahl M, Bewersdorf JP, Giri S, et al. Use of immunosuppressive therapy for management of myelodysplastic syndromes: a systematic review and meta-analysis. Haematologica. 2020; 105(1): 102–111.
- Stahl M, DeVeaux M, de Witte T, et al. The use of immunosuppressive therapy in MDS: clinical outcomes and their predictors in a large international patient cohort. Blood Adv. 2018; 2(14): 1765–1772.
- Tobiasson M, Dybedahl I, Holm MS, et al. Limited clinical efficacy of azacitidine in transfusion-dependent, growth factor-resistant, low- and Int-1-risk MDS: Results from the nordic NMDSG08A phase II trial. Blood Cancer J. 2014; 4: e189.
- Thépot S, Ben Abdelali R, Chevret S, et al. Groupe Francophone des Myélodysplasies (GFM). A randomized phase II trial of azacitidine +/- epoetin-β in lower-risk myelodysplastic syndromes resistant to erythropoietic stimulating agents. Haematologica. 2016; 101(8): 918–925.
- Lyons RM, Cosgriff TM, Modi SS, et al. Hematologic response to three alternative dosing schedules of azacitidine in patients with myelodysplastic syndromes. J Clin Oncol. 2009; 27(11): 1850–1856.
- Leitch HA, Parmar A, Wells RA, et al. Overall survival in lower IPSS risk MDS by receipt of iron chelation therapy, adjusting for patient-related factors and measuring from time of first red blood cell transfusion dependence: an MDS-CAN analysis. Br J Haematol. 2017; 179(1): 83–97.
- Malcovati L, Porta MG, Pascutto C, et al. Prognostic factors and life expectancy in myelodysplastic syndromes classified according to WHO criteria: a basis for clinical decision making. J Clin Oncol. 2005; 23(30): 7594–7603.
- Waszczuk-Gajda A, Mądry K, Machowicz R, et al. Red blood cell transfusion dependency and hyperferritinemia are associated with impaired survival in patients diagnosed with myelodysplastic syndromes: results from the first Polish MDS-PALG Registry. Adv Clin Exp Med. 2016; 25(4): 633–641.
- de Witte T, Bowen D, Robin M, et al. Allogeneic hematopoietic stem cell transplantation for MDS and CMML: recommendations from an international expert panel. Blood. 2017; 129(13): 1753–1762.
- Majhail NS, Lazarus HM, Burns LJ. A prospective study of iron overload management in allogeneic hematopoietic cell transplantation survivors. Biol Blood Marrow Transplant. 2010; 16(6): 832–837.
- Brissot E, Savani BN, Mohty M. Management of high ferritin in long-term survivors after hematopoietic stem cell transplantation. Semin Hematol. 2012; 49(1): 35–42.
- Angelucci E, Greenberg P, Izquierdo M, et al. Iron chelation in transfusion-dependent patients with low- to intermediate-1-risk myelodysplastic syndromes. Ann Intern Med. 2020; 173(7): 595–596.
- Fenaux P, Mufti G, Hellstrom-Lindberg E, et al. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study. Lancet Oncol. 2009; 10(3): 223–232.
- Knipp S, Hildebrand B, Kündgen A, et al. Intensive chemotherapy is not recommended for patients aged >60 years who have myelodysplastic syndromes or acute myeloid leukemia with high-risk karyotypes. Cancer. 2007; 110(2): 345–352.
- Mozessohn L, Cheung MC, Fallahpour S, et al. Azacitidine in the 'real-world': an evaluation of 1101 higher-risk myelodysplastic syndrome/low blast count acute myeloid leukaemia patients in Ontario, Canada. Br J Haematol. 2018; 181(6): 803–815.
- Itzykson R, Thépot S, Quesnel B, et al. Prognostic factors for response and overall survival in 282 patients with higher-risk myelodysplastic syndromes treated with azacitidine. Blood. 2011; 117(2): 403–411.
- Carreras E, Dufour C, Mohty M M, Kröger NT. The EBMT handbook: hematopoietic stem cell transplantation and cellular therapies. Springer International Publishing, [MIASTO??] 2018.
- Porta MD, Alessandrino E, Bacigalupo A, et al. Predictive factors for the outcome of allogeneic transplantation in patients with MDS stratified according to the revised IPSS-R. Blood. 2014; 123(15): 2333–2342.
- Vaughn JE, Storer BE, Armand P, et al. Design and validation of an augmented Hematopoietic Cell Transplantation-Comorbidity Index comprising pretransplant ferritin, albumin, and platelet count for prediction of outcomes after allogeneic transplantation. Biol Blood Marrow Transplant. 2015; 21(8): 1418–1424.
- Lim Z, Brand R, Martino R, et al. Allogeneic hematopoietic stem-cell transplantation for patients 50 years or older with myelodysplastic syndromes or secondary acute myeloid leukemia. J Clin Oncol. 2010; 28(3): 405–411.
- Potter VT, Iacobelli S, van Biezen A, et al. Comparison of intensive chemotherapy and hypomethylating agents before allogeneic stem cell transplantation for advanced myelodysplastic syndromes: a study of the Myelodysplastic Syndrome Subcommittee of the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplant Research. Biol Blood Marrow Transplant. 2016; 22(9): 1615–1620.
- Gagelmann N, Eikema DJ, Stelljes M, et al. Optimized EBMT transplant-specific risk score in myelodysplastic syndromes after allogeneic stem-cell transplantation. Haematologica. 2019; 104(5): 929–936.
- Kröger N, Iacobelli S, Franke GN, et al. Dose-reduced versus standard conditioning followed by allogeneic stem-cell transplantation for patients with myelodysplastic syndrome: a prospective randomized phase III study of the EBMT (RICMAC trial). J Clin Oncol. 2017; 35(19): 2157–2164.
- Koreth J, Pidala J, Perez WS, et al. Role of reduced-intensity conditioning allogeneic hematopoietic stem-cell transplantation in older patients with de novo myelodysplastic syndromes: an international collaborative decision analysis. J Clin Oncol. 2013; 31(21): 2662–2670.
- Festuccia M, Deeg HJ, Gooley TA, et al. Minimal identifiable disease and the role of conditioning intensity in hematopoietic cell transplantation for myelodysplastic syndrome and acute myelogenous leukemia evolving from myelodysplastic syndrome. Biol Blood Marrow Transplant. 2016; 22(7): 1227–1233.
- Deeg HJ, Stevens EA, Salit RB, et al. Transplant conditioning with treosulfan/fludarabine with or without total body irradiation: a randomized phase II trial in patients with myelodysplastic syndrome and acute myeloid leukemia. Biol Blood Marrow Transplant. 2018; 24(5): 956–963.
- Wedge E, Sengeløv H, Hansen JW, et al. Improved outcomes after allogenic hematopoietic stem cell transplantation with fludarabine/treosulfan for patients with myelodysplastic syndromes. Biol Blood Marrow Transplant. 2020; 26(6): 1091–1098.
- Bazarbachi A, Schmid C, Labopin M, et al. Evaluation of trends and prognosis over time in patients with AML relapsing after allogeneic hematopoietic cell transplant reveals improved survival for young patients in recent years. Clin Cancer Res. 2020; 26(24): 6475–6482.
- Rautenberg C, Bergmann A, Germing U, et al. Prediction of response and survival following treatment with azacitidine for relapse of acute myeloid leukemia and myelodysplastic syndromes after allogeneic hematopoietic stem cell transplantation. Cancers (Basel). 2020; 12(8): 2255.
- Schuurhuis GJ, Heuser M, Freeman S, et al. Minimal/measurable residual disease in AML: a consensus document from the European LeukemiaNet MRD Working Party. Blood. 2018; 131(12): 1275–1291.
- Terwijn M, van Putten WLJ, Kelder A, et al. High prognostic impact of flow cytometric minimal residual disease detection in acute myeloid leukemia: data from the HOVON/SAKK AML 42A study. J Clin Oncol. 2013; 31(31): 3889–3897.
- Czyz A, Nagler A. The role of measurable residual disease (MRD) in hematopoietic stem cell transplantation for hematological malignancies focusing on acute leukemia. Int J Mol Sci. 2019; 20(21).
- Tsirigotis P, Byrne M, Schmid C, et al. Relapse of AML after hematopoietic stem cell transplantation: methods of monitoring and preventive strategies. A review from the ALWP of the EBMT. Bone Marrow Transplant. 2016; 51(11): 1431–1438.
- Lion T, Watzinger F, Preuner S, et al. The EuroChimerism concept for a standardized approach to chimerism analysis after allogeneic stem cell transplantation. Leukemia. 2012; 26(8): 1821–1828.
- Quek L, Ferguson P, Metzner M, et al. Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia. Blood Adv. 2016; 1(3): 193–204.
- Steinmann J, Bertz H, Wäsch R, et al. 5-Azacytidine and DLI can induce long-term remissions in AML patients relapsed after allograft. Bone Marrow Transplant. 2015; 50(5): 690–695.
- Schroeder T, Rachlis E, Bug G, et al. Treatment of acute myeloid leukemia or myelodysplastic syndrome relapse after allogeneic stem cell transplantation with azacitidine and donor lymphocyte infusions — a retrospective multicenter analysis from the German Cooperative Transplant Study Group. Biol. Blood Marrow Transplan. 2015; 21(4): 653–660.
- Greiner J, Götz M, Bunjes D, et al. Immunological and clinical impact of manipulated and unmanipulated DLI after allogeneic stem cell transplantation of AML patients. J Clin Med. 2019; 9(1).
- DeFilipp Z, Chen YB. Strategies and challenges for pharmacological maintenance therapies after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2016; 22(12): 2134–2140.
- Schroeder T, Rautenberg C, Haas R, et al. Hypomethylating agents after allogeneic blood stem cell transplantation. Stem Cell Investig. 2016; 3: 84.
- Oran B, Lima Mde, Garcia-Manero G, et al. A phase 3 randomized study of 5-azacitidine maintenance vs observation after transplant in high-risk AML and MDS patients. Blood Adv. 2020; 4(21): 5580–5588.
- Craddock C, Labopin M, Robin M, et al. Clinical activity of azacitidine in patients who relapse after allogeneic stem cell transplantation for acute myeloid leukemia. Haematologica. 2016; 101(7): 879–883.
- Platzbecker U, Wermke M, Radke J, et al. Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial. Leukemia. 2012; 26(3): 381–389.
- Schmid C, Labopin M, Nagler A, et al. Donor lymphocyte infusion in the treatment of first hematological relapse after allogeneic stem-cell transplantation in adults with acute myeloid leukemia: a retrospective risk factors analysis and comparison with other strategies by the EBMT Acute Leukemia Working Party. Journal of Clinical Oncology. 2007; 25(31): 4938–4945.
- Schroeder T, Rautenberg C, Haas R, et al. Hypomethylating agents for treatment and prevention of relapse after allogeneic blood stem cell transplantation. Int J Hematol. 2018; 107(2): 138–150.
- Durrani J, Maciejewski J. Idiopathic aplastic anemia vs hypocellular myelodysplastic syndrome. Hematology. 2019; 2019(1): 97–104.
- Bono E, McLornan D, Travaglino E, et al. Clinical, histopathological and molecular characterization of hypoplastic myelodysplastic syndrome. Leukemia. 2019; 33(10): 2495–2505.
- Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016; 127(20): 2375–2390.
- Melody M, Al Ali N, Zhang L, et al. Decoding bone marrow fibrosis in myelodysplastic syndromes. Clin Lymphoma Myeloma Leuk. 2020; 20(5): 324–328.
- Zahr AA, Salama ME, Carreau N, et al. Bone marrow fibrosis in myelofibrosis: pathogenesis, prognosis and targeted strategies. Haematologica. 2016; 101(6): 660–671.
- Kröger N, Zabelina T, van Biezen A, et al. MDS Subcommittee of the Chronic Leukemia Working Party (CLWP) of the European Group for Blood and Marrow Transplantation (EBMT). Allogeneic stem cell transplantation for myelodysplastic syndromes with bone marrow fibrosis. Haematologica. 2011; 96(2): 291–297.
- Candelaria M, Dueñas-Gonzalez A. Therapy-related myelodysplastic syndrome. Expert Opin Drug Saf. 2015; 14(5): 655–665.
- Bhatia S. Therapy-related myelodysplasia and acute myeloid leukemia. Semin Oncol. 2013; 40(6): 666–675.
- Quintás-Cardama A, Daver N, Kim H, et al. A prognostic model of therapy-related myelodysplastic syndrome for predicting survival and transformation to acute myeloid leukemia. Clin Lymphoma Myeloma Leuk. 2014; 14(5): 401–410.
- Fianchi L, Criscuolo M, Fabiani E, et al. Therapy-related myeloid neoplasms: clinical perspectives. Onco Targets Ther. 2018; 11: 5909–5915.
- Caira M, Latagliata R, Girmenia C. The risk of infections in patients with myelodysplastic syndromes in 2016. Expert Rev Hematol. 2016; 9(6): 607–614.
- Goldberg SL, Chen Er, Corral M, et al. Incidence and clinical complications of myelodysplastic syndromes among United States Medicare beneficiaries. J Clin Oncol. 2010; 28(17): 2847–2852.
- Sullivan LR, Sekeres MA, Shrestha NK, et al. Epidemiology and risk factors for infections in myelodysplastic syndromes. Transpl Infect Dis. 2013; 15(6): 652–657.
- Gil L. [Infectious complication after allogeneic stem cell transplantation] [Article in Polish]. Acta Haematol Pol. 2010; 41(3): 363–370.
- Dayyani F, Conley AP, Strom SS, et al. Cause of death in patients with lower-risk myelodysplastic syndrome. Cancer. 2010; 116(9): 2174–2179.
- Mądry K, Lis K, Biecek P, et al. Predictive model for infection risk in myelodysplastic syndromes, acute myeloid leukemia, and chronic myelomonocytic leukemia patients treated with azacitidine; azacitidine infection risk model: the Polish Adult Leukemia Group Study. Clin Lymphoma Myeloma Leuk. 2019; 19(5): 264–274.e4.
- Latagliata R, Niscola P, Fianchi L, et al. Pulmonary infections in patients with myelodysplastic syndromes receiving frontline azacytidine treatment. Hematol Oncol. 2020; 38(2): 189–196.
- Musto P, Maurillo L, Spagnoli A, et al. Ad Hoc Italian Cooperative Study Group on Azacitidine in Myelodysplastic Syndromes Acute Leukemias. Azacitidine for the treatment of lower risk myelodysplastic syndromes : a retrospective study of 74 patients enrolled in an Italian named patient program. Cancer. 2010; 116(6): 1485–1494.
- Schuck A, Goette MC, Neukirchen J, et al. A retrospective study evaluating the impact of infectious complications during azacitidine treatment. Ann Hematol. 2017; 96(7): 1097–1104.
- Mossuto S, Attardi E, Alesiani F, et al. SARS-CoV-2 in myelodysplastic syndromes: a snapshot from early Italian experience. Hemasphere. 2020; 4(5): e483.
- Toma A, Fenaux P, Dreyfus F, et al. Infections in myelodysplastic syndromes. Haematologica. 2012; 97(10): 1459–1470.
- Lee JH, Lee KH, Lee JH, et al. Decreased incidence of febrile episodes with antibiotic prophylaxis in the treatment of decitabine for myelodysplastic syndrome. Leuk Res. 2011; 35(4): 499–503.
- Pomares H, Arnan M, Sánchez-Ortega I, et al. Invasive fungal infections in AML/MDS patients treated with azacitidine: a risk worth considering antifungal prophylaxis? Mycoses. 2016; 59(8): 516–519.
- Platzbecker U, Fenaux P, Steensma D, et al. Imerge: a phase 3 study to evaluate imetelstat in transfusion-dependent subjects with IPSS low or intermediate-1 risk myelodysplastic syndromes (MDS) that is relapsed/refractory to erythropoiesis-stimulating agent (ESA) treatment. Blood. 2020; 136(Supplement 1): 17–17.
- Henry DH, Glaspy J, Harrup R, et al. Oral roxadustat demonstrates efficacy in anemia secondary to lower-risk myelodysplastic syndrome irrespective of ring sideroblasts and baseline erythropoietin levels. Blood. 2020; 136(Suppl 1): 29–30.
- Garcia JS, Wei A, Borate U, et al. Safety, efficacy, and patient-reported outcomes of venetoclax in combination with azacitidine for the treatment of patients with higher-risk myelodysplastic syndrome: a phase 1b study. Blood. 2020; 136(Supplement 1): 55–57.
- Zeidan MA, Pollyea DA, Garcia JC, et al. 3109 a phase 1b study evaluating the safety and efficacy of venetoclax in combination with azacitidine for the treatment of relapsed/refractory myelodysplastic syndrome. 62nd ASH Annual Meeting and Exposition 2020. https://ash.confex.com/ash/2020/webprogram/Paper136413.html (October 18, 2021).
- Moyo TK, Watts J, Skikne B, et al. Preliminary results from a phase II study of the combination of pevonedistat and azacitidine in the treatment of MDS and MDS/MPN after failure of DNA methyltransferase inhibition. Blood. 2019; 134(Suppl_1): 4236–4236.
- Sekeres MA, Watts JM, Radinoff A, et al. 653 Efficacy and safety of pevonedistat plus azacitidine vs azacitidine alone in higher-risk myelodysplastic syndromes (MDS) from Study P-2001 (NCT02610777) . https://ash.confex.com/ash/2020/webprogram/Paper135840.html (October 18, 2021).
- Sallman DA, Asch AS, Al Malki MM, et al. The first-in-class anti-CD47 antibody magrolimab (5F9) in combination with azacitidine is effective in MDS and AML patients: ongoing phase 1b results. Blood. 2019; 134(Suppl_1): 569–569.
- Sallman DA, DeZern A, Garcia-Manero G, et al. Eprenetapopt (APR-246) and azacitidine in TP53-mutant myelodysplastic syndromes. J Clin Oncol. 2021; 39(14): 1584–1594.
- Navada SC, Garcia-Manero G, Atallah E, et al. Phase II study of oral rigosertib combined with azacitidine (AZA) as first line therapy in patients (Pts) with higher-risk myelodysplastic syndromes (HR-MDS). Blood. 2019; 134(Suppl_1): 566–566.