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Management of Hematological Cancer in Older People pp 49–61Cite as

Myelodysplastic Syndromes in Older Patients

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Abstract

Myelodysplastic syndromes (MDS) represent typical diseases of the elderly. MDS cover a broad spectrum of clonal hematopoietic stem cell diseases characterized by a dysplastic hematopoiesis and cytopenias in the peripheral blood. Clinical manifestations of MDS are variable and range from mild symptoms related to anemia, thrombocytopenia or granulocytopenia to the transformation to acute myeloid leukemia. The availability of promising treatment options including disease-modifying agents and supportive therapy, imposes the need to develop strategies and algorithms for individualized risk assessment and treatment algorithms in elderly MDS-patients.

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References

  1. Germing U, Strupp C, Kundgen A, Bowen D, Aul C, Haas R, Gattermann N. No increase in age-specific incidence of myelodysplastic syndromes. Haematologica. 2004;89(8):905–10.

    PubMed  Google Scholar 

  2. de Swart L, Smith A, Fenaux P, Symenonidis A, Hellström-Lindberg E, Sanz G, Cermak J, Georgescu O, Germing U, MacKenzie M, Beyne-Rauzy O, Malcovati L, Stauder R, Droste J, Bowen D, de Witte T. Management of 1000 patients with low- and intermediate-1 risk myelodysplastic syndromes in the European LeukemiaNet MDS Registry. Leuk Res. 2011; S3(7):Supplement 1.

    Google Scholar 

  3. Pfeilstöcker M, Karlic H, Nösslinger T, Sperr W, Stauder R, Krieger O, Valent P. Myelodysplasia and aging: differences and common features in biology and clinic. Leukemia and Lymphoma. 2007;48(10):1900–9.

    Article  PubMed  Google Scholar 

  4. Stauder R, Noesslinger T, Pfeilstöcker M, Sperr WR, Wimazal F, Krieger O, Valent P. Impact of age and comorbidity in myelodysplastic syndromes. J Natl Compr Canc Netw. 2008;6(9):927–34.

    PubMed  Google Scholar 

  5. Stauder R. The challenge of personalized risk assessment and therapy planning in elderly high-risk myelodysplastic syndromes (MDS) patients. Ann Hematol. 2012;91(9):1333–43.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Neukirchen J, Schoonen WM, Strupp C, Gattermann N, Aul C, Haas R, Germing U. Incidence and prevalence of myelodysplastic syndromes: data from the Düsseldorf MDS-registry. Leuk Res. 2011;35(12):1591–6.

    Article  PubMed  Google Scholar 

  7. Stauder R, Wimazal F, Nösslinger T, Krieger O, Sperr WR, Sill H, Pfeilstöcker M, Valent P. Individualized management and therapy of myelodysplastic syndromes. Wien Klin Wochenschr. 2008;120:523–37.

    Article  PubMed  Google Scholar 

  8. Schanz J, Tüchler H, Solé F, Mallo M, Luño E, Cervera J, Granada I, Hildebrandt B, Slovak ML, Ohyashiki K, Steidl C, Fonatsch C, Pfeilstöcker M, Nösslinger T, Valent P, Giagounidis A, Aul C, Lübbert M, Stauder R, Krieger O, Garcia-Manero G, Faderl S, Pierce S, Le Beau MM, Bennett JM, Greenberg P, Germing U, Haase D. New comprehensive cytogenetic scoring system for primary myelodysplastic syndromes (MDS) and oligoblastic acute myeloid leukemia after MDS derived from an international database merge. J Clin Oncol. 2012;30(8):820–9.

    Article  PubMed  Google Scholar 

  9. Greenberg P, Cox C, LeBeau MM, Fenaux P, Morel P, Sanz G, Sanz M, Vallespi T, Hamblin T, Oscier D, Ohyashiki K, Toyama K, Aul C, Mufti G, Bennett J. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997;89(6):2079–88.

    CAS  PubMed  Google Scholar 

  10. Kantarjian H, O’Brien S, Ravandi F, Cortes J, Shan J, Bennett JM, List A, Fenaux P, Sanz G, Issa JP, Freireich EJ, Garcia-Manero G. Proposal for a new risk model in myelodysplastic syndrome that accounts for events not considered in the original International Prognostic Scoring System. Cancer. 2008;113(6):1351.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Garcia-Manero G. Myelodysplastic syndromes: 2014 update on diagnosis, risk-stratification, and management. Am J Hematol. 2014;89(1):97–108.

    Google Scholar 

  12. Nösslinger T, Tüchler H, Germing U, Sperr WR, Krieger O, Haase D, Lübbert M, Stauder R, Giagounidis A, Valent P, Pfeilstöcker M. Prognostic impact of age and gender in 897 untreated patients with primary myelodysplastic syndromes. Ann Oncol. 2010;21(1):120–5.

    Article  PubMed  Google Scholar 

  13. Malcovati L, Porta MG, Pascutto C, Invernizzi R, Boni M, Travaglino E, Passamonti F, Arcaini L, Maffioli M, Bernasconi P, Lazzarino M, Cazzola M. Prognostic factors and life expectancy in myelodysplastic syndromes classified according to WHO criteria, a basis for clinical decision making. J Clin Oncol. 2005;23(30):7594–603.

    Article  PubMed  Google Scholar 

  14. Valent P, Horny HP, Bennett JM, Fonatsch C, Germing U, Greenberg P, Haferlach T, Haase D, Kolb HJ, Krieger O, Loken M, van de Loosdrecht A, Ogata K, Orfao A, Pfeilstöcker M, Rüter B, Sperr WR, Stauder R, Wells DA. Definitions and standards in the diagnosis and treatment of myelodysplastic syndromes: consensus statements and report from a working conference. Leukemia Research. 2007;31(6):727–36.

    Article  PubMed  Google Scholar 

  15. Platzbecker U, Santini V, Mufti GJ, Haferlach C, Maciejewski JP, Park S, Solé F, van de Loosdrecht AA, Haase D. Update on developments in the diagnosis and prognostic evaluation of patients with myelodysplastic syndromes (MDS): consensus statements and report from an expert workshop. Leuk Res. 2012;36(3):264–70.

    Article  PubMed  Google Scholar 

  16. Bruning RD, Orazi A, Germing U, Le Beau MM, Porwit A, Baumann I, et al. Myelodysplastic syndromes. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW, editors. World Health Organization classification of tumours of the hematopoietic and lymphoid tissues. 4th ed. Lyon: International Agency for Research on Cancer; 2008.

    Google Scholar 

  17. Greenberg PL, Tuechler H, Schanz J, Sanz G, Garcia-Manero G, Solé F, Bennett JM, Bowen D, Fenaux P, Dreyfus F, Kantarjian H, Kuendgen A, Levis A, Malcovati L, Cazzola M, Cermak J, Fonatsch C, Le Beau MM, Slovak ML, Krieger O, Luebbert M, Maciejewski J, Magalhaes SM, Miyazaki Y, Pfeilstöcker M, Sekeres M, Sperr WR, Stauder R, Tauro S, Valent P, Vallespi T, van de Loosdrecht AA, Germing U, Haase D. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012;120(12):2454–65.

    Article  CAS  PubMed  Google Scholar 

  18. Malcovati L, Della Porta MG, Cazzola M. Predicting survival and leukemic evolution in patients with myelodysplastic syndrome. Haematologica. 2006;91(12):1588–90.

    PubMed  Google Scholar 

  19. Hellström-Lindberg E, Gulbrandsen N, Lindberg G, Ahlgren T, Dahl IM, Dybedal I, Grimfors G, Hesse-Sundin E, Hjorth M, Kanter-Lewensohn L, Linder O, Luthman M, Löfvenberg E, Oberg G, Porwit-MacDonald A, Rådlund A, Samuelsson J, Tangen JM, Winquist I, Wisloff F, Scandinavian MDS Group. A validated decision model for treating the anaemia of myelodysplastic syndromes with erythropoietin+G-CSF: significant effects on quality of life. Br J Haematol. 2003;120(6):1037–46.

    Article  PubMed  Google Scholar 

  20. Greenberg PL, Sun Z, Miller KB, Bennett JM, Tallman MS, Dewald G, Paietta E, van der Jagt R, Houston J, Thomas ML, Cella D, Rowe JM. Treatment of MDS patients with erythropoietin with or without G-CSF: results of a prospective randomized phase 3 trial by the Eastern Cooperative Oncology Group (E1996). Blood. 2009;114:2393.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Jädersten M, Malcovati L, Dybedal I, Della Porta MG, Invernizzi R, Montgomery SM, Pascutto C, Porwit A, Cazzola M, Hellström-Lindberg E. Erythropoietin and G-CSF treatment associated with improved survival in MDS. J Clin Oncol. 2008;26(21):3607–13.

    Article  PubMed  Google Scholar 

  22. Park S, Grabar S, Kelaidi C, Beyne-Rauzy O, Picard F, Bardet V, Coiteux V, Leroux G, Lepelley P, Daniel MT, Cheze S, Mahé B, Ferrant A, Ravoet C, Escoffre-Barbe M, Adès L, Vey N, Aljassem L, Stamatoullas A, Mannone L, Dombret H, Bourgeois K, Greenberg P, Fenaux P, Dreyfus F, GFM group (Groupe Francophone des Myélodysplasies). Predictive factors of response and survival in myelodysplastic syndrome treated with erythropoietin and G-CSF: the GFM experience. Blood. 2008;111(2):574–82.

    Article  CAS  PubMed  Google Scholar 

  23. Valent P, Krieger O, Stauder R, Wimazal F, Nösslinger T, Sperr WR, Sill H, Bettelheim P, Pfeilstöcker M. Iron overload in myelodysplastic syndromes (MDS) – diagnosis, treatment, and response criteria: a proposal of the Austrian MDS platform. Eur J Clin Invest. 2008;38(3):143–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Jädersten M, Saft L, Smith A, Kulasekararaj A, Pomplun S, Göhring G, Hedlund A, Hast R, Schlegelberger B, Porwit A, Hellström-Lindberg E, Mufti GJ. TP53 mutations in low-risk myelodysplastic syndromes with del(5q) predict disease progression. J Clin Oncol. 2011;29(15):1971–9.

    Article  PubMed  Google Scholar 

  25. Sloand EM, Olnes MJ, Shenoy A, Weinstein B, Boss C, Loeliger K, Wu CO, More K, Barrett AJ, Scheinberg P, Young NS. Alemtuzumab treatment of intermediate-1 myelodysplasia patients is associated with sustained improvement in blood counts and cytogenetic remissions. J Clin Oncol. 2010;28(35):5166–73. Epub 2010 Nov 1.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Fenaux P, Mufti GJ, Hellstrom-Lindberg E, Santini V, Finelli C, Giagounidis A, Schoch R, Gattermann N, Sanz G, List A, Gore SD, Seymour JF, Bennett JM, Byrd J, Backstrom J, Zimmerman L, McKenzie D, Beach C, Silverman LR, International Vidaza High-Risk MDS Survival Study Group. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher risk myelodysplastic syndromes: a randomised, open-label, phase III study. Lancet Oncol. 2009;10(3):223–32.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Seymour JF, Fenaux P, Silverman LR, Mufti GJ, Hellström-Lindberg E, Santini V, List AF, Gore SD, Backstrom J, McKenzie D, Beach CL. Effects of azacitidine compared with conventional care regimens in elderly (≥75 years) patients with higher-risk myelodysplastic syndromes. Crit Rev Oncol Hematol. 2010;76(3):218–27.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Itzykson R, Thépot S, Quesnel B, Dreyfus F, Beyne-Rauzy O, Turlure P, Vey N, Recher C, Dartigeas C, Legros L, Delaunay J, Salanoubat C, Visanica S, Stamatoullas A, Isnard F, Marfaing-Koka A, de Botton S, Chelghoum Y, Taksin AL, Plantier I, Ame S, Boehrer S, Gardin C, Beach CL, Adès L, Fenaux P, Groupe Francophone des Myelodysplasies(GFM). Prognostic factors for response and overall survival in 282 patients with higher-risk myelodysplastic syndromes treated with azacitidine. Blood. 2011;117(2):403–11.

    Article  CAS  PubMed  Google Scholar 

  29. Kantarjian H, Issa JP, Rosenfeld CS, Bennett JM, Albitar M, DiPersio J, et al. Decitabine improves patient outcomes in myelodysplastic syndromes: results of a phase III randomized study. Cancer. 2006;106(8):1794–803.

    Article  CAS  PubMed  Google Scholar 

  30. Lübbert M, Suciu S, Baila L, Rüter BH, Platzbecker U, Giagounidis A, et al. Low-dose decitabine versus best supportive care in elderly patients with intermediate- or high-risk myelodysplastic syndrome (MDS) ineligible for intensive chemotherapy: final results of the randomized phase III study of the European Organisation for Research and Treatment of Cancer Leukemia Group and the German MDS Study Group. J Clin Oncol. 2011;29(15):1987–96.

    Article  PubMed  Google Scholar 

  31. Sperr WR, Wimazal F, Kundi M, Baumgartner C, Nösslinger T, Makrai A, Stauder R, Krieger O, Pfeilstöcker M, Valent P. Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core data Set of 582 patients of the Austrian MDS platform. Ann Oncol. 2010;21(1):114–9.

    Article  CAS  PubMed  Google Scholar 

  32. Naqvi K, Garcia-Manero G, Sardesai S, Oh J, Vigil CE, Pierce S, Lei X, Shan J, Kantarjian HM, Suarez-Almazor ME. Association of comorbidities with overall survival in myelodysplastic syndrome: development of a prognostic model. J Clin Oncol. 2011;29(16):2240–6. Epub 2011 May 2.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Wang R, Gross CP, Halene S, Ma X, et al. Comorbidities and survival in a large cohort of patients with newly diagnosed myelodysplastic syndromes. Leuk Res. 2009;33(12):1594–8.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Bammer C, Sperr WR, Kemmler G, Wimazal F, Nösslinger T, Schönmetzler A, Krieger O, Pfeilstöcker M, Valent P, Stauder R. Clustering of comorbidities is related to age and sex and impacts clinical outcome in myelodysplastic syndromes. J Geriatr Oncol. 2014;5(3):299–306.

    Google Scholar 

  35. Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009;114(5):937–51.

    Article  CAS  PubMed  Google Scholar 

  36. Hamaker ME, Mitrovic M, Stauder R. The G8 screening tool detects relevant geriatric impairments and predicts survival in elderly patients with a haematological malignancy. Ann Hematol. 2014;93(6):1031–40.

    Google Scholar 

  37. Hamaker ME, Prins MC, Stauder R. The relevance of a geriatric assessment for elderly patients with a haematological malignancy – a systematic review. Leuk Res. 2014;38(3):275–83.

    Google Scholar 

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Acknowledgement

Supported by Senioren-Krebshilfe, www.senioren-krebshilfe.at.

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Authors and Affiliations

  1. Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Anichstraße 35, Innsbruck, 6020, Austria

    Reinhard Stauder MD, MSc

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  1. Reinhard Stauder MD, MSc
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Correspondence to Reinhard Stauder MD, MSc .

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Editors and Affiliations

  1. Department of Palliative Care, University Hospital Jena, Jena, Thüringen, Germany

    Ulrich Wedding

  2. St Helens Teaching Hospital, University of Liverpool, St Helens, United Kingdom

    Riccardo A. Audisio

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Stauder, R. (2015). Myelodysplastic Syndromes in Older Patients. In: Wedding, U., Audisio, R. (eds) Management of Hematological Cancer in Older People. Springer, London. https://doi.org/10.1007/978-1-4471-2837-3_3

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  • DOI: https://doi.org/10.1007/978-1-4471-2837-3_3

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