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Review Article
Medical Progress
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Volume 340:1649-1660 May 27, 1999 Number 21
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Myelodysplasia
Mark L. Heaney, M.D., Ph.D., and David W. Golde, M.D.

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The myelodysplastic syndromes are clonal hematologic disorders characterized clinically and morphologically by ineffective hematopoiesis. The natural history of these syndromes ranges from a chronic course that may span years to a rapid course of leukemic progression. Unfortunately, the nomenclature and classification systems used to describe these conditions are cumbersome and contentious. Nonetheless, myelodysplastic syndromes are viewed by most hematologists as encompassing stages of neoplastic hematopoiesis associated with cytopenias and as excluding nonneoplastic conditions. In general, myelodysplastic conditions are preleukemic disorders in which the neoplastic clone is established, but not all cases of myelodysplasia terminate in acute myeloid leukemia (AML). Here, . . . [Full Text of this Article]

The Hematopoietic Stem Cell and Its Neoplastic Transformation

History and Classification of Myelodysplasia

Pathogenesis, Pathophysiology, and Molecular Pathology

Diagnosis

Clinical Syndromes and Manifestations

The 5q– Syndrome

Hypoplastic Myelodysplasia

Childhood Myelodysplasia

Myelodysplasia with Bone Marrow Fibrosis

Therapy-Related Myelodysplasia

Treatment

Chemotherapy

Agents with Novel Mechanisms of Action

Immunotherapy

Hematopoietic Hormones and Cytokines

Stem-Cell Transplantation

Overall Approach to Treatment

Future Treatment


Source Information

From the Department of Medicine (M.L.H., D.W.G.) and the Program in Molecular Pharmacology and Therapeutics (D.W.G.), Memorial Sloan-Kettering Cancer Center, New York.

Address reprint requests to Dr. Golde at Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021, or at d-golde@ski.mskcc.org.

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