Myelodysplasia and the acute myeloid leukaemias
Date
2002
Authors
Jacobs P.
Wood L.
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Abstract
The myelodysplastic syndromes are increasingly recognised clinical entities reflecting a stem cell defect that gives rise to ineffective clonal haematopoiesis. The spectrum extends from relatively indolent refractory anaemia through varying combinations of leucopoenia and thrombocytopenia to acute leukaemia. Diagnosis rests on marrow hypercellularity with dysplastic morphology, apoptosis and, often distinctive cytogenetic defects. Stratification to risk-related protocols range from occasional blood transfusions or erythropoietin through innovative options including thalidomide or amifostine to haematopoietic stem cell transplantation in selected individuals. Acute myeloid leukaemia, conceptually segregated from preleukaemia, is treated differently although accumulating cellular and molecular data favour a more integrated approach. Morphology and immunophenotyping are complemented by molecular genetics. On this basis chemotherapy alone is sufficient in defined subgroups whereas others benefit by autologous or allogeneic grafting. Attention to demonstrating minimal residual disease is the basis for more specific intervention exemplified by monoclonal antibodies or maturation-inducing agents as with retinoic acid in acute progranulocytic leukaemia.
Description
Keywords
amifostine, anthracycline antibiotic agent, ciprofloxacin, cyclosporin A, cytarabine, cytokine, danazol, dexamethasone, erythropoietin, granulocyte colony stimulating factor, granulocyte macrophage colony stimulating factor, human immunoglobulin, methylprednisolone, monoclonal antibody, pentoxifylline, prednisone, retinoic acid, thalidomide, acute granulocytic leukemia, acute leukemia, apoptosis, article, blood transfusion, cancer chemotherapy, cell structure, clinical protocol, cytogenetics, hematopoiesis, hematopoietic stem cell, hematopoietic stem cell transplantation, human, immunophenotyping, leukemogenesis, leukopenia, minimal residual disease, myelodysplasia, preleukemia, priority journal, refractory anemia, risk assessment, thrombocytopenia, Acute Disease, Humans, Leukemia, Myeloid, Molecular Diagnostic Techniques, Myelodysplastic Syndromes, Prognosis
Citation
Hematology
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