შეჯამება
განსაზღვრება
ანამნეზი და გასინჯვა
ძირითადი დიაგნოსტიკური ფაქტორები
- older age
- fatigue
- exercise intolerance
- pallor
- bruising or bleeding
- prior chemotherapy and/or radiation therapy
- congenital disorder
- bacterial infections
სხვა დიაგნოსტიკური ფაქტორები
- autoimmune disorders
- splenomegaly
- hepatomegaly
- lymphadenopathy
რისკფაქტორები
- age >70 years
- prior chemotherapy
- prior radiation therapy
- prior autologous hematopoietic stem cell transplantation
- congenital disorders
- tobacco
- benzene
- aplastic anemia
- paroxysmal nocturnal hemoglobinuria (PNH)
დიაგნოსტიკური კვლევები
1-ად შესაკვეთი გამოკვლევები
- CBC with differential
- peripheral blood smear
- reticulocyte count
- red blood cell folate
- serum vitamin B12
- iron studies
- bone marrow aspiration with iron stain
- bone marrow core biopsy
- genetic testing
Tests to avoid
- fluorescence in situ hybridization (FISH)
გასათვალისწინებელი კვლევები
- viral serology
- serum erythropoietin
- lactate dehydrogenase
- HLA typing
- flow cytometry
მკურნალობის ალგორითმი
lower-risk disease: asymptomatic
lower-risk disease: MDS-5q (del(5q) ± one other cytogenetic abnormality except those involving chromosome 7) with symptomatic anemia
lower-risk disease: MDS-SF3B1 (no del(5q) ± other cytogenetic abnormalities with ring sideroblasts ≥15% [or ≥5% with an SF3B1 mutation]) with symptomatic anemia
lower-risk disease: no del(5q) with ring sideroblasts <15% (or <5% with an SF3B1 mutation) with symptomatic anemia
lower-risk disease: with clinically relevant thrombocytopenia or neutropenia (without symptomatic anemia)
higher-risk disease: transplant candidate
higher-risk disease: nontransplant candidate
კონტრიბუტორები
ავტორები
Vijaya Raj Bhatt, MBBS, MS
Associate Professor
Section Leader, Malignant Hematology
University of Nebraska Medical Center Division of Hematology-Oncology
Nebraska
NE
გაფრთხილება:
VRB has participated in a Safety Monitoring Committee for Protagonist Therapeutics and served as an Associate Editor for the journal Current Problems in Cancer. He has received consulting fees from Taiho, Sanofi, Imugene, Genentech, Incyte, Servier Pharmaceuticals, and AbbVie; research funding (institutional) from MEI Pharma, Actinium Pharmaceutical, Sanofi, AbbVie, Pfizer, Incyte, Jazz, and NMDP; and drug support (institutional) from Chimerix for a trial.
Prajwal Dhakal, MBBS
Clinical Assistant Professor of Internal Medicine-Hematology, Oncology, and Blood and Marrow Transplantation
University of Iowa
Iowa City
IA
გაფრთხილება:
PPD has been reimbursed by the Aplastic Anemia and MDS International Foundation for presenting on the topic "High-risk MDS: non-transplant therapies, current therapies, and clinical trials" in a patient and family conference. PD has received consulting fees from AbbVie pharmaceuticals.
მადლიერება
Dr Vijaya Raj Bhatt and Dr Prajwal Dhakal would like to gratefully acknowledge Professor Apar Kishor Ganti and Associate Professor Alissa Marr, previous contributors to this topic.
გაფრთხილება:
AKG has received research support from Amgen, Apexigen, Bristol-Myers Squibb, Janssen, Merck, New Link Genetics, Pfizer, and Takeda Oncology. AKG has been reimbursed for consulting work for AbbVie and Genentech. None of the grants or payments relate to work involving myelodysplastic syndrome. AM declares that she has no competing interests.
რეცენზენტები
David P. Steensma, MD, FACP
Associate Professor of Medicine (Hematology) and Oncology
Division of Hematology
Department of Medicine
Mayo Clinic
Rochester
MN
გაფრთხილება:
DPS declares that he has no competing interests.
Adrian C. Newland, BA, MB, BCh, MA, FRCP, FRCPath
Professor of Haematology
Queen Mary University
London
UK
გაფრთხილება:
ACN declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
წყაროები
ძირითადი სტატიები
Killick SB, Wiseman DH, Quek L, et al. British Society for Haematology guidelines for the diagnosis and evaluation of prognosis of adult myelodysplastic syndromes. Br J Haematol. 2021 Jul;194(2):282-93.სრული ტექსტი აბსტრაქტი
Killick SB, Ingram W, Culligan D, et al. British Society for Haematology guidelines for the management of adult myelodysplastic syndromes. Br J Haematol. 2021 Jul;194(2):267-81.სრული ტექსტი აბსტრაქტი
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: myelodysplastic syndromes [internet publication].სრული ტექსტი
Fenaux P, Haase D, Santini V, et al; ESMO Guidelines Committee. Myelodysplastic syndromes: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021 Feb;32(2):142-56.სრული ტექსტი აბსტრაქტი
გამოყენებული სტატიები
ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია მომხმარებლებისთვის, რომლებსაც აქვთ წვდომა BMJ Best Practice-ის ყველა ნაწილზე.
დიფერენციული დიაგნოზები
- Aplastic anemia
- HIV infection
- Other viral infections (e.g., parvovirus, CMV, or hepatitis)
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- NCCN clinical practice guidelines in oncology: myelodysplastic syndromes
- British Society for Haematology guidelines for the management of adult myelodysplastic syndromes
მეტი გაიდლაინები
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