Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Myelodysplastic Syndrome
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Myelodysplastic Syndrome
    Conventional Cytogenetics Usually Adequate Way to Test for Primary Myelodysplastic Syndrome: Presented at ASCP - (DGDispatch)
    Anaemic Patients With MDS Benefit From Erythropoietin, Myeloid Growth Factor Hormones - (DGNews)
    Hypomethylating Agents Show Better Efficacy Than Best Supportive Care in Patients With Myelodysplastic Syndrome: Presented at EHA - (DGDispatch)
    Mutation in TET2 in myeloid cancers - (N Engl J Med)
    Azacitidine Approved in EU for Myelodysplastic Syndromes, AML - (DGNews)

    News archive

     Recent webcasts/CME - Myelodysplastic Syndrome
  • Exploring New Trends in MDS & AML: From Clinical Data in Poor-Prognosis Patients to Mechanisms of Novel Agents
  • Interpreting New Findings on Epigenetic Changes in MDS and AML-What Impact Will They Have on Treatment?
  • Bone Marrow Failure Syndromes Optimizing Outcomes Worldwide through Disease Understanding

    Webcasts/CME archive

     Recent cases - Myelodysplastic Syndrome
      Miliary Tuberculosis with no Pulmonary Involvement in Myelodysplastic Syndromes: A Curable, Yet Rarely Diagnosed, Disease: Case Report and Review of the Literature
      Extensive Myocardial Infiltration by Hemopoietic Precursors in a Patient with Myelodysplastic Syndrome
      A Case of Generalised Cutaneous Granulocytic Sarcoma in an Elderly Patient with Myelodysplastic Syndrome

      Cases archive
        




      my personal edition > myelodysplastic syndrome > news
      divider

        E-Mail this DGDispatch to a colleague

      DGDispatch


      Therapies for Myelodysplastic Syndrome Only Improve Survival in Distinct Patient Subgroups: Presented at MDS

        By Alison Palkhivala

        FLORENCE, ITALY -- May 23, 2007 -- Treatments for myelodysplastic syndrome (MDS) only provide a survival benefit in certain subsets of patients, according to a matched-pair analysis presented here at the 9th International Symposium on Myelodysplastic Syndromes (MDS).

        To date, only MDS patients receiving best supportive care have been evaluated for prognosis, said presenter Katherin Nachtkamp, MD, department of haematology and oncology, Heinrich-Heine University, Düsseldorf, Germany.

        It is therefore unclear whether new therapies improve survival or only serve to ameliorate haematological parameters and quality of life. To determine the prognostic impact of these therapies, Dr. Nachtkamp and colleagues performed a matched pair analysis on 3,125 patients from the Düsseldorf MDS registry, and evaluated antithymocyte globulin (ATG), thalidomide, valproic acid, low-dose arabinoside C (AraC), induction chemotherapy, and allogeneic stem cell transplantation (ASCT) compared with best supportive care.

        Notably, prognosis among patients who received best supportive care did not change based on year of diagnosis, which ranged from 1970 to 2005. Survival was significantly longer among the 55 patients in the registry who received thalidomide, compared with best supportive care (33 vs 25 months, P =.0291).

        Looking at patients based on their International Prognostic Scoring System (IPSS) scores revealed that a survival benefit with thalidomide was only evident in those with IPSS scores of 2 and 3 (31 vs 8 months, P =.0070).

        Both treatment with ASCT (n = 39) and ATG (n = 17) improved overall survival in the groups receiving these therapies (40 vs 14 months, P =.0498 and 158 vs 61 months, P =.0447, respectively). ASCT was particularly effective in patients with IPSS scores of 2 or 3 (65 vs 8 months, P =.0017).

        Valproic acid treatment (n = 76) was also associated with a longer survival time (48 vs 29 months, P =.0325) in the overall group, but was particularly effective in patients with refractory anaemia with excess blasts (RAEB) classification I and II, and RAEB in transition (48 vs 10 months, P =.0036).

        Low-dose AraC (n = 65) only improved survival in patients with IPSS scores of 2 or 3 (18 vs 7 months, P =.0294), while induction chemotherapy (n = 172) only improved survival in patients with RAEB II and RAEB in transition who were under 60 years of age (22 vs 11 months, P =.0431)

        "Treatment is not necessarily associated with an improvement in survival," Dr. Nachtkamp said. "A superior outcome in comparison with nontreated patients could only be shown in certain patient subgroups, such as high-risk MDS patients treated with thalidomide, AraC, or ASCT, and low-risk patients who were given AGT."

        But she also warned, "The results of matched analyses should not be overinterpreted. It is an inferior methodology in comparison with phase 3 studies. In addition, we have to consider that it is easier to demonstrate a survival benefit in high-risk [compared with low-risk] patients."

        Dr. Nachtkamp also noted that even if treatment does not affect overall survival, improvements in haematological parameters and quality of life remain good rationales for treating chronic conditions such as MDS.


        [Presentation title: Influence of Different Treatment Strategies on the Prognosis of Patients With Myelodysplastic Syndromes (MDS). Abstract C014]




      E-Mail this DGDispatch to a colleague   To print, use this version






      All contents Copyright (c) 1995-2009 Doctor's Guide Publishing Limited. All rights reserved.



      The NTK initiative. Physicians helping physicians identify Need-To-Know science
         Feedback
      Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
      Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
      1
      2
      3
      4
      5
      6
      7
      Send