Diagnostics and Management of Myelodysplastic Syndromes

Dear Colleagues,

Myelodysplastic syndrome (MDS) comprises a number of clonal bone marrow diseases most frequently diagnosed in patients older than 50 years, that are characterized by peripheral blood cytopenias in the face of a normal or hypercellular bone marrow, and lead to leukemia in approximately  a quarter of patients. Bone marrow failure in this syndrome is the consequence of immune-mediated intramedullary death (also known as ‘pyroptosis’) of bone marrow progenitors, readily demonstrable by pathological examination. Their etiology is largely unknown, although a number of situations can contribute to its development, namely genetic predisposition, exposure to different chemicals or radiations, autoimmune diseases, etc. MDS clinical evolution is highly variable, and patient prognosis can be estimated by means of a combination of genetic findings, bone marrow blast proportion enumeration, number and degree of peripheral blood cytopenias, as well as other ancillary findings. For years, blood transfusion and hematopoietic cell transplantation have been the cornerstones of their management, but in the last few decades, a better understanding of the molecular defects operating in MDS has fostered a complex armamentarium led by erythroid stimulating agents, followed by lenalidomide and hypomethylating agents, and now complemented by a number of new agents that help to prolong survival and improve patient quality of life. This Special Issue on MDS aims to bring this syndrome closer to the practicing physician, and help our colleagues deal with this old group of diseases, by using an updated clinical approach for their diagnosis, prognosis and treatment.

Dr. Fernando Ramos
Guest Editor

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