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Myelodysplastic syndromes are clonal hematopoietic stem-cell disorders characterized by chronic peripheral blood cytopenias and a hypercellular bone marrow. Hematopoietic stem cells transplantation is presently the only curative treatment for MDS, while other therapeutics like intensive chemotherapies and hypomethylating agents, only have the potential to improve the patient’s overall survival. The latter recently appeared for the treatment of MDS in Europe, and aroused great expectations on these therapies. Even they effectively bring new possibilities for patients; their improvement was not as great as expected. New questions are now raised up for their optimal use in MDS. This work aims to determine the position of hypomethylating agents towards other therapies and to suggest some lines of thought for new issues they raise. Les syndromes myélodysplasiques (SMD) englobent une série de troubles affectant les cellules souches hématopoïétiques. Les patients atteints de cette pathologie ont la particularité de présenter des cytopénies périphériques chroniques, tout en ayant une moelle osseuse riche en progéniteurs myéloïdes. Actuellement, la greffe de cellules souches hématopoïétiques est le seul traitement curatif pour les SMD, tandis que les autres options thérapeutique s, comme la chimiothérapie et les agents hypométhylants, ne laissent au mieux qu'un espoir de prolonger la survie du patient. Ces derniers sont récemment apparus sur le marché, et ont alors suscité de grandes attentes dans le traitement des SMD. Bien qu'apportant de nouvelles perspectives pour les patients, ils n 'ont malheureusement pas aussi bien répondu à ces attentes, et laissent par contre de nouvelles interrogations quant à leur usage optimal dans ce type de pathologie. Ce travail a pour but de positionner le rôle de ces nouvelles molécules par rapport aux traitements existants, et de proposer quelques pistes de réflexion quant aux interrogations que laissent les agents hypométhylants.
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MYELODYSPLASTIC SYNDROMES --- MYELODYSPLASTIC SYNDROMES --- BONE MARROW EXAMINATION --- BLOOD --- GENETICS --- MYELODYSPLASTIC SYNDROMES --- MYELODYSPLASTIC SYNDROMES --- BONE MARROW EXAMINATION --- BLOOD --- GENETICS
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Myelodysplastic Syndromes was first published in 2006, and continues to stand out as the definitive text on the genetics, pathophysiology, and clinical management of this wide range of syndromes. It remains a major reference on all aspects of the clinical classification underlying pathogenetic mechanisms and treatment of the myelodysplastic syndromes. Authored by international experts, the book provides an assessment of the subject's status and a variety of advances in the field. The chapters cover all aspects of the myelodysplastic syndromes, from an in-depth analysis of the multifactorial nature of this disease, including a careful assessment of stromal, immunological and stem cell abnormalities, to a review of recent molecular and cytogenetic discoveries and insights. This book will be a valuable resource to clinicians and researchers who wish to learn more about myelodysplastic syndromes.
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Myelodysplastic Syndromes --- Bone Marrow --- genetics --- pathology
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Myelodysplastic syndromes. --- Bone marrow --- Dysmyelopoietic syndromes --- Dysplasia --- Syndromes --- Preleukemia --- Diseases
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