Myelodysplastic Syndromes

Given the advances in the knowledge of the disease biology and pathogenesis of MDS, as well as advances in optimization of supportive care and treatment, MDS patients have a longer survival and require thoughtful treatment planning with intentional sequencing of effective therapies. Careful selection of patients on the basis of molecular alterations found in the MDS clone in addition to clinical characteristics and incorporation of these data is fundamental if not to deliver a cure, to ensure the optimal treatment.

Dr. Valeria Santini will present the landscape of treatments that are available for lower risk MDS patients. Challenges in the diagnosis and prognostication of these MDS patients will be reviewed. Discussion on how best to optimize treatment choices based on the selection of patients and the appropriate use of standard and experimental therapies will be analyzed.

Dr. Hetty Carraway will review the criteria for definition of failure of hypomethylating agents and will provide an overview of the mechanisms of resistance to hypomethylating therapy. The activity in relapsed/refractory MDS of novel formulations and/or combinations of epigenetic agents will be discussed as well as how to utilize molecular mutational data to best direct future therapeutic choices.

Dr. Mary Horowitz will explore recent advances in strategies to minimize regimen-related toxicity and graft-versus-host disease to make hematopoietic stem cell transplant a viable option for a larger number of MDS patients. Appropriate timing of transplant and appropriate selection of patients will be discussed, including use of geriatric assessment tools and co-morbidity scales.