The myelodysplastic syndromes: current approaches to therapy
Article Abstract:
Myelodysplastic syndromes are a group of five fatal blood disorders characterized by abnormal or immature blood cells. Patients afflicted with these disorders frequently develop acute myeloid leukemia,a progressive malignant disease of the blood-forming cells that results in the uncontrolled production of immature white blood cells and their precursors. Because of the wide diversity of subtypes within the five disorders, definitive prognostic indicators have not been agreed upon, but include such factors as the age of the patient, an abnormal decrease in white blood cells, red blood cells or platelets, and the presence of immature blood cells. Standard therapy for myelodysplastic syndromes is supportive and includes: chemotherapeutic agents that kill the abnormal blood cells; growth factors (differentiating agents) that promote the formation of normal blood cells, but which also may facilitate the progression to leukemia; and bone marrow transplantation, which is the only therapy that may produce a cure. Patients with poor prognostic indicators should be treated with intense chemotherapy, with or without differentiating agents or bone marrow transplantation. Patients with good prognostic indicators should be treated with differentiating agents. All of these therapies should be the focus clinical studies to advance the understanding and treatment of these disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1990
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Splenic extramedullary hematopoiesis in a patient receiving intermittently administered granulocyte colony-stimulating factor
Article Abstract:
A patient treated with granulocyte colony-stimulating factor (G-CSF) and chemotherapy for lymphoma developed splenic extramedullary hematopoiesis with an enlarged spleen that was later removed. Extramedullary hematopoiesis refers to the production of blood cells in organs other than bone marrow. G-CSF is often used in conjunction with chemotherapy to prevent infections during treatment. During the course of treatment for the lymphoma, the patient developed anemia and received a blood transfusion. Extramedullary hematopoiesis is sometimes associated with severe anemia. Enlargement of the spleen was noted and it was removed three weeks after the last G-CSF therapy and six weeks after completion of chemotherapy. Clinicians should be aware that even intermittent doses of G-CSF may cause enlargement of the spleen.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1993
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