Chapters authored
Diagnosis and Classification of Myelodysplastic Syndrome
Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disorder characterized by morphological dysplastic changes in one or more of the major hematopoietic cell lines. MDS can present with varying degrees of single or multiple cytopenias including neutropenia, anemia and thrombocytopenia. Presentation of MDS can range from asymptomatic to life threatening. MDS diagnosis and classification present important challenges, particularly in the distinction from benign conditions. French-American-British (FAB) classification proposed a classification based on easily obtainable laboratory information and was recommended in early and as modified by guidelines of new classification of World Health Organization (WHO). The strategy of diagnostic laboratory in MDS depends on morphological changes and is based on existence of dysplastic changes in the peripheral blood and bone marrow including peripheral blood smear, bone marrow aspirate smear and bone marrow trephine biopsy. The correct morphological interpretation and the use of cytogenetics, immunophenotyping, immunohistochemistry and molecular analysis will give valuable information on diagnosis and prognosis.
Part of the book: Recent Developments in Myelodysplastic Syndromes
Target Therapy in Hematological Malignancies
Molecular target therapy is a recently rapid progress in the management of hematological malignancies. In myeloid neoplasm, the sensational response to treatment and the overall survival and quality of life improvement for treatment with tyrosine kinase inhibitors (TKI) agents for patients with chronic myeloid leukemia and the introduction of Janus kinase (JAK)-2 inhibitors (ruxolitinib) may offer comparative advantage in myeloproliferative diseases of patients with polycythemia vera (PV), primary myelofibrosis (MF) and essential thrombocythemia (ET). The introduction of all-trans-retinoic acid (ATRA) and mylotarg for acute myeloid leukemia patients, have had major impacts on the treatment protocol plan and different other targeted therapeutic highly effective agents, including FLT3, histone deacetylase inhibitors and farnesyl transferase. In malignant lymphomas and lymphatic leukemia the feature has been the presentation of rituximab, with critical enhancements within the treatment of chronic lymphocytic leukemia and non-Hodgkin’s lymphoma. The most recent 15 years has encountered a rapidly broadening interest and acknowledgment that leukemic stem cells, including an enhanced capacity to target them, may hold the way to enhanced reaction and diminished relapse rates over both lymphoid and myeloid disorders. Technical regulation for growing new personalized anticancer target therapy agents have changed and presently evaluated and screened.
Part of the book: Advances in Hematologic Malignancies