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2020, Number 3

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Rev Cubana Hematol Inmunol Hemoter 2020; 36 (3)

Myelodysplastic syndromes: beyond hypomethylating agents

Fernández DND, Trujillo PHJ

Language: Spanish
References: 35
Page:
PDF size: 368.64 Kb.


ABSTRACT

Introduction: The heterogeneous characteristics of myelodysplastic syndromes, as well as the progress in recent years in the field of genetics and molecular biology, have led to the appearance of multiple investigations with different therapeutic approaches. Hypomethylating agents are so far the standard treatment for this entity, but unfortunately they are not effective in 100% of cases and the duration of their response is variable.
Objective: To analyze current therapeutic options for the treatment of myelodysplastic syndromes.
Methods: A literature review was carried out, in English and Spanish, through the PubMed website and the Google Scholar search engine, for articles published in the last five years. An analysis and summary of the revised bibliography was carried out.
Information analysis and synthesis: Currently, there are multiple treatment options, most of which are directed against fundamental epigenetic events: hypermethylation, modification of histone diacetylase, and activation of the cytotoxic immune response against abnormal clones. However, as long as a single alteration has not been established, treatments, in most protocols, are adapted to risk and include a small number of cases, while their outcomes are limited.
Conclusions: It is considered that a possible solution is to direct treatment to specific alteration based on molecular alterations and precision medicine, fundamentally in refractory or relapsed patients after treatment with current hypomethylating agents.


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