Park Sophie
CHU de Grenoble, service d'hématologie, CS 10217, 38043 Grenoble cedex 09, France.
Bull Cancer. 2023 Nov;110(11):1156-1161. doi: 10.1016/j.bulcan.2023.02.027. Epub 2023 Jul 25.
For low-risk myelodysplastic syndromes, the goal of treatment is to correct cytopenias or their consequences. Erythropoiesis-stimulating agents have an important role in the management of anemia. In this chapter, we will detail the response to ESAs, the factors predictive of response to ESAs. However, the search for new therapeutic options for low-risk, ESA-resistant MDS remains necessary as the incidence of AML transformation of the patients is higher. We can retain luspatercept for MDS with excess ring of sideroblasts, lenalidomide, and some molecules currently being tested such as imetelstat or roxedustat. However, the search for new therapeutic options for ESA-resistant low-risk MDS remains necessary. We can use androgenotherapy or TPO agonists in limited access for symptomatic thrombocytopenia.
对于低风险骨髓增生异常综合征，治疗目标是纠正血细胞减少症或其后果。促红细胞生成素在贫血管理中发挥重要作用。在本章中，我们将详细阐述对促红细胞生成素的反应、预测促红细胞生成素反应的因素。然而，由于患者急性髓系白血病转化的发生率较高，寻找针对低风险、促红细胞生成素抵抗性骨髓增生异常综合征的新治疗选择仍然很有必要。对于伴有过多环形铁粒幼细胞的骨髓增生异常综合征，我们可以选用罗特西普、来那度胺，以及一些目前正在测试的分子，如艾美司他或罗沙司他。然而，寻找针对促红细胞生成素抵抗性低风险骨髓增生异常综合征的新治疗选择仍然很有必要。对于有症状的血小板减少症，我们可以在有限的情况下使用雄激素疗法或血小板生成素激动剂。
