Nuevo abordaje terapéutico en el síndrome mielodisplasico de alto riesgo

Abstract

Myelodysplastic syndrome (MDS) is an acquired clonal disease of the hematopoietic progenitor cells of the bone marrow that affects a small part of the population worldwide. Its treatment is based on the patient's risk. The only therapeutic approach is allogeneic stem cell transplantation. The use of hypomethylating drugs is considered a bridge therapy to achieve complete remission of the patient. Considering that the number of patientsrefractory to hypomethylating agents is very high, it is necessary to look for different strategies. This literature review aims to study the new therapeutic approach in high-risk MDS. The new therapies available for high-risk myelodysplastic syndrome are described. Target therapies, such as immune checkpoint inhibitors, have shown promising results. Magrolimab and azacitidine have positive results, with overall response rates of 91% and a complete remission higher than 50% in six months. New approaches that look for action mechanisms focused on the patient's cytogenetics, as in the case of the TP53 gene, in which there is a poor prognosis for patients. Venetoclaxhas an overall survival of 75% for patients with this mutation. Results showed that the different molecular targets have a promising future; unfortunately, more clinical studies are necessary due to the failure of Hypomethylation agents or their use in combination with other drugs to improve the prognosis in high-risk patients