Research progress on choice of hypomethylating treatment in myelodysplastic syndromes

Abstract

The clinical manifestation and outcome of myelodysplastic syndrome(MDS) are highly heterogeneous. It is important to choose personal treatment plan according to risk groups, age, performance status and compliance. The overall response rate of hypomethylaing treatment in MDS is 40%-60%. Hypomethylating agents should be considered for fit patients who have 5% or more bone marrow blasts or who are with adverse cytogenetic characteristics. Platelets count ≥100×109/L and white blood cell count <3.0×109/L independently predict better response. The treatment of patients with HLA-DR1501 phenotype remains controversial. TET2 mutation, DNMT3A mutation, ASXL1 wild type are independent predictors of better response. This review summaries the current research progress of hypomethylating treatment in MDS on prognostic group, clinical indicators and gene mutation. Key words: Myelodysplastic syndromes; Hypomethylating agents; Decitabine; Gene mutation