Journal of Blood Disorders & Transfusion

Management of higher risk myelodysplastic syndrome

4^th International Conference on Blood Malignancies & Treatment

April 18-19, 2016 Dubai, UAE

Inga Mandac Rogulj

Clinical Hospital Merkur, Croatia

Scientific Tracks Abstracts: J Blood Disord Transfus

Abstract:

Higher risk myelodysplastic syndromes (MDS) include patients in the intermediate and high-risk categories of the International Prognostic Scoring System and are associated with excess blasts, poor-risk cytogenetics and multiple cytopenias. Survival in untreated higher-risk MDS patients is 6 months following diagnosis and for that reason the goal of therapy is to prolong survival and delay progression to acute myeloid leukemia. At present time, different guidelines recommend initial treatment with one of the hypomethylating agents (HMA), azacitidine or decitabine. Only azacitidine has been shown to prolong survival in comparison to conventional care regimens but results have shown that the median survival advantage is only 9.5 months. Among patients with initial responses to HMAs, the median response duration is 9-15 months. Many data indicate that as many as 40% of patients do not respond to treatment or subsequently relapse. After HMA failure, no standard of care has been defined and many combination treatment strategies have shown variety results. Suggested treatment options for HMA failure include allogeneic stem cell transplantation (in case of eligible patient), addition of other drugs to HMA, enrollment in clinical trials if available or best supportive care. Patients who progress to AML should be offered intensive chemotherapy but data suggest poor response rates. Allogeneic SCT is the only treatment option with a possibility of cure in front line or for relapsed/refractory HR-MDS suitable patients. In conclusion, HR-MDS patients who face a poor prognosis need new treatment options to improve their outcomes.

Biography :

Inga Mandac Rogulj is an attending Physician in Internal Medicine and Hematology at Clinical Hospital Merkur in Zagreb, Croatia. She has graduated from School of Medicine at the University of Zagreb. She has joined the Clinical Faculty in the Division of Hematology at Clinical Hospital Merkur where she continues her Clinical Practice. Her research interest is focused on lymphoproliferative disorders, myelodysplastic syndrome, chronic leukemias and multiple myeloma. She has given invited lectures at domestic and international meetings and has authored several abstracts and scientific papers in peer-reviewed journals.

Email: imandac@yahoo.com