Managing the Myelodysplastic Syndrome Patient Through Transplantation

The myelodysplastic syndromes (MDS) have often been called the poster child for apoptosis gone awry: in some cases death (to hematopoietic progenitors) comes too infrequently, in other cases it comes too readily. The quest to better understand its basis and to translate this understanding into therapeutics is only beginning, but already several therapies have emerged and others are in development. For now, there is only one curative therapy for MDS: hematopoietic cell transplantation (HCT).

Insights Into Early Empiric or Prophylactic Antifungal Therapy in a Transplant Setting

Invasive fungal infections have become the chief infectious threat to allogeneic hematopoietic cell transplant (HCT) recipients. New drugs such as the echinocandins (caspofungin, micafungin, and anidulafungin) and the extended-spectrum azoles (itraconazole, voriconazole, and posaconazole) offer more effective and safer options today. Although these potent antifungal agents make treatment prospects better, there still is considerable risk for death from Candida, Aspergillus, and other mold infections.

Improving the Treatment of Hematologic Malignancies: Chronic Lymphocytic Leukemia

This Grand Rounds in Hematology monograph, Improving the Treatment of Hematologic Malignancies:
Chronic Lymphocytic Leukemia, is based on our selection of key abstracts from the ASH meeting in December 2006 and related publications in the following areas of chronic lymphocytic leukemia (CLL): new advances in prognosis, approaches to frontline therapy including the use of chemoimmunotherapies, management of the relapsed refractory patient, and, finally, novel drugs for the treatment of CLL.

Posttransplantation Patient Care: Tailored Prevention and Management Strategies

For years, considerable attention was devoted to just getting it right: figuring out how to do a transplantation as safely as possible and preventing acute complications during the first 100 days from unraveling the effort. Tremendous advances in transplantation practice have made this therapy safer and outcomes have improved. In recent years, attention has shifted increasingly to other important considerations.

Before and After Transplantation: Treatment Strategies for Patients with Myelodysplastic Syndromes

Management of myelodysplastic syndrome has been disappointing for years. The mainstay approach was only supportive care. A malaise settled all around. Today there are new Food and Drug Administration cleared therapies, and novel agents are on the horizon. True progress has been small to date, but with the number of new therapies and new classes of agents undergoing study, the future is hopeful.

ASBMT Evidence-Based Reviews for Pediatric and Adult Acute Lymphoblastic Leukemia

The American Society for Blood and Marrow Transplantation (ASBMT) has supported the conduct of a series of evidence-based reviews exploring the role of hematopoietic cell transplantation (HCT) in various hematologic disorders over the past several years. This abridged report summarizes the major findings of two recent reviews addressing the role of HCT in the management of acute lymphoblastic leukemia, one review in children, the other in adults.

New Era of Preparative Regimens: Controlled Ablation and Reduced Toxicity

The three prime ingredients of allogeneic hematopoietic cell transplantation (HCT) are conditioning regimen, graft, and posttransplantation supportive care. For decades, much of the research interest has focused on the latter two ingredients. Characterization of graft hematopoietic and immune constituents and manipulation of these elements have led to important insights, new knowledge, and improved outcomes.