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The Myelodysplastic Syndromes: Pathobiology and Clinical Management

2002 Edition, May 21, 2002

Complete Document

Detail Summary

Active, Most Current

Additional Comments:
ISBN: 978-0-8247-0782-8
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Product Details:

  • Revision: 2002 Edition, May 21, 2002
  • Published Date: May 21, 2002
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 558
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


The myelodysplastic syndromes (MDS) are a group of potentially acute myeloid leukemic disorders that have attracted considerable interest over the past two decades. A delicate balance exists between accelerated program cell death (apoptosis) and proliferation of the leukemic hematopoietic stem cell that permits many patients to survive for years, but when the balance shifts toward proliferation of the leukemic clone, acute myeloid leukemia (AML) develops, with a poor outcome for most but not all patients. Best estimates indicate that the incidence of MDS is at least twice as common as AML. With the vast majority of cases occurring over the age of 70 years, therapeutic options that have been available for ‘‘de novo'' AML are often not utilized.

As the median age of our population increases, more cases will be recognized. In addition, the successful application of combination chemotherapy and radiation therapy has resulted in long-term remissions and cure of an increasing number of neoplasms. Unfortunately, a small percentage of these patients (varying from 1% to as high as 15%) will develop MDS/AML as a result of the therapy. This could contribute an additional 10% to the overall incidence.

Progress in understanding the pathobiology of MDS has evolved rapidly, as have an increasing number of myeloablative and supportive care strategies. In this book I have solicited chapters from many of the world's leading authorities to provide current and timely information for those involved with the diagnosis and management of patients with MDS.

The book contains 18 chapters that cover the entire range of MDS, including the recent changes in classification by the World Health Organization; a review of the incidence and prevalence of MDS; insights into possible exogenous factors that could contribute to the causation of MDS; cytogenetics and molecular genetics; the relationship between hypocellularMDS, AML, and aplastic anemia; and the critical importance of the role of apoptosis. The mid-section encompasses prognostic factors and response criteria, mechanisms of drug resistance, and a most provocative chapter on pediatric MDS patients. The final chapters discuss the importance of recognizing patients who would benefit from supportive care programs including erythropoietin, growth factors and immune modulation as well as new approaches, including anti-antigenic agents, anti-cytosine agents and new agents that appear to interfere with important biological pathways such as farnesyl transferase inhibitors. The book concludes with detailed discussions of intensive chemotherapy, auto- and allo-bone marrow transplantation, and a summary chapter on overall approaches to patient care management.

This volume provides a wealth of information by many of the world's leading authorities on the pathogenesis, staging, and management strategies on the most common neoplastic hematological disorder recognized today. It should be of considerable interest to hematopathologists, hematologists, and clinicians who are involved in the diagnosis and care of patients with MDS. In addition, scientists engaged in developing new agents for hematological neoplasms will find the chapters of considerable value in understanding the rationale for the urgent need for novel pharmaceuticals to improve the survival and quality of life for our patients.