Löffler H, Schmitz N, Gassmann W
Second Department of Internal Medicine, University of Kiel, Germany.
Hematol Oncol Clin North Am. 1992 Jun;6(3):619-31.
In myelodysplastic syndromes (MDS), complete remission rates of acute myelogenous leukemia (AML)-type chemotherapeutic regimens vary widely, ranging from 15% in patients with myelodysplasia after previous cytotoxic therapy to 61% in patients with refractory anemia with an excess of blasts in transformation without previous exposure to leukemogenic chemicals. The duration of remission is usually short, and those that exceed 24 months are unusual. Results of treatment are identical in the different types of MDS. No sufficient data on aggressive therapy are available for refractory anemia and refractory anemia with ringed sideroblasts. Prognostically favorable subgroups of patients are defined by age (below 45 or 50 years), no prior history of cytotoxic drug exposure, and absence of cytogenetic aberrations, especially of chromosomes 5 and/or 7. In contrast to AML-type chemotherapy, allogeneic bone marrow transplantation following high-dose (radio) chemotherapy offers a significantly greater chance of cure with a long-term relapse-free survival rate of 30% to 60%.
在骨髓增生异常综合征（MDS）中，急性髓系白血病（AML）型化疗方案的完全缓解率差异很大，范围从既往接受过细胞毒性治疗的骨髓发育异常患者中的15%到转化型原始细胞增多的难治性贫血且既往未接触过致白血病化学物质的患者中的61%。缓解期通常较短，超过24个月的情况并不常见。不同类型的MDS治疗结果相同。对于难治性贫血和伴有环形铁粒幼细胞的难治性贫血，尚无足够的积极治疗数据。预后良好的患者亚组由年龄（45岁或50岁以下）、既往无细胞毒性药物接触史以及无细胞遗传学异常（尤其是5号和/或7号染色体）来定义。与AML型化疗不同，大剂量（放疗）化疗后进行异基因骨髓移植提供了显著更高的治愈机会，长期无复发生存率为30%至60%。
