Current and emerging strategies for management of myelodysplastic syndromes
Abstract
Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis with varying degrees of dysplasia and peripheral cytopenias. MDS are driven by structural chromosomal alterations and somatic mutations in neoplastic myeloid cells, which are supported by a tumorigenic and a proinflammatory marrow microenvironment. Current treatment strategies for lower-risk MDS focus on improving quality of life and cytopenias, while prolonging survival and delaying disease progression is the focus for higher-risk MDS. Several promising drugs are in the horizon, including the hypoxia-inducible factor stabilizer roxadustat, telomerase inhibitor imetelstat, oral hypomethylating agents (CC-486), TP53 modulators (APR-246 and ALRN-6924), and the anti-CD47 antibody magrolimab. Targeted therapies approved for acute myeloid leukemia treatment, such as isocitrate dehdyrogenase inhibitors and venetoclax, are also being studied for use in MDS. In this review, we provide a brief overview of pathogenesis and current treatment strategies in MDS followed by a discussion of newer agents that are under clinical investigation.
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In preclinical mouse models, ALRN-6924 has shown activity as a radio-protectant that also prevents chemotherapy-induced toxicity.
“In preclinical mouse models, ALRN-6924 has shown activity as a radio-protectant that also prevents chemotherapy-induced toxicity.217,395,396”
From Recent advances in targeting the “undruggable” proteins: from drug discovery to clinical trials (2023) · cites this paper as [396]
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Recent advances in targeting the “undruggable” proteins: from drug discovery to clinical trials
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- Authors
- Saygin, C., & Carraway, H. E.
- Affiliations
- University of Chicago (US)
- Cleveland Clinic (US)
- Corresponding author
- Carraway, Hetty E.
- Venue
- Blood Reviews
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 48
- Pages
- 100791
- ISSN
- 0268-960X (ISSN-L)
- OpenAlex
- W3117581628
- Cited by
- 70
- References
- 141
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 11 · 2023: 18 · 2022: 12 · 2021: 10
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Blood Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Keywords
- myelodysplastic syndrome, ineffective hematopoiesis, cytopenia, chromosomal abnormalities, somatic mutations, bone marrow microenvironment, roxadustat, imetelstat, telomerase inhibitors, hypomethylating agents, CC-486, APR-246, magrolimab, anti-CD47 antibody, isocitrate dehydrogenase inhibitors, venetoclax, targeted therapy, MDS pathogenesis
- MeSH terms
- Bone Marrow, Combined Modality Therapy, Disease Susceptibility, Humans, Myelodysplastic Syndromes, Biomarkers, Treatment Outcome, Disease Management, Genetic Predisposition to Disease, Tumor Microenvironment, Symptom Assessment
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