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HERO ID
7439079
Reference Type
Journal Article
Title
Treatment Algorithms for Lower-Risk Myelodysplastic Syndrome
Author(s)
Fenaux, P; Adès, L; ,
Year
2020
Publisher
Springer International Publishing
Location
Cham
Book Title
Diagnosis and Management of Myelodysplastic Syndromes
Page Numbers
131-145
PMID
31650290
DOI
10.1007/978-3-030-51878-3_8
Web of Science Id
WOS:000492348900003
URL
http://link.springer.com/10.1007/978-3-030-51878-3_8
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Abstract
Myelodysplastic syndromes (MDS) are hematopoietic stem cell malignancies associated with an erythroid maturation defect, resulting in anemia. Treatments for MDS include erythropoiesis-stimulating agents (ESAs). The identification of prognostic markers is important to help predict response and improve outcomes. Various scoring systems have been developed to help predict response to ESAs. Despite limitations in its assessment, serum erythropoietin (sEPO) level is an important predictor of hematologic response to ESAs in patients with lower-risk MDS. Numerous studies have reported significantly lower sEPO levels among responders versus non-responders. Furthermore, treatment response is significantly more likely among those with sEPO levels below versus those above various cutoffs. Other prognostic indicators for response to ESAs include lower transfusion requirement, fewer bone marrow blasts, higher hemoglobin, lower serum ferritin, lower-risk MDS, and more normal cytogenetics. Studies of other MDS therapies (e.g., lenalidomide and luspatercept) have also reported that lower sEPO levels are indicative of hematologic response. In addition, lower sEPO levels (up to 500 IU/L) have been included in treatment algorithms for patients with lower-risk MDS to define whether ESAs are indicated. Lower sEPO levels are predictive of hematologic response-particularly to ESAs. Further, clinical trials should use sEPO thresholds to ensure more homogeneous cohorts.
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