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Practical Advice for Managing Myelodysplastic Syndrome


Concluding their discussion on myelodysplastic syndrome management, experts share final pearls of wisdom.

Bart Scott, MD, MS: An important thing for health care providers to remember about MDS [myelodysplastic syndrome] is that it’s a heterogeneous disease; it’s many different diseases in one. The patients should be treated as individuals, and their overall goals of care and care plan should be a discussion with the patients and what they wish to do. I would emphasize that, in general, most patients are undertreated rather than overtreated.

Amer Zeidan, MBBS, MHS: Myelodysplastic syndromes are some of the more difficult cancers to understand because of all the differences that we discussed throughout the last hour. Trying to understand the disease and trying to understand the patients’ needs are very important. We are entering an era in which we are going to have more therapies and more segmentation of patients into subgroups based on molecular or other biomarkers to choose therapy, similar to what has happened in AML [acute myeloid leukemia]. We are going to continue in that direction. We are going to have more clinical trials looking at combination-based therapies, and we potentially have the first combination, with azacitidine and venetoclax approved in AML. There are trials looking at different combinations in MDS. Therapy is going to become more complex. Those patients will have to be treated in collaboration with experienced physicians who are more up to date on the data, and we’ll have to establish algorithms or clinical pathways to try to treat these patients in the most effective way, which is looking both at the efficacy as well as a quality-of-life and reducing inconvenience for patients in terms of these therapies. If we cannot cure most patients, the goal would be to try to prolong survival as much as possible and maintain a good quality of life and transfusion independence.

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