ASH 2012: Dr. David P Steensma: Myelodysplastic Syndrome with a Focus on Secondary MDS in CLL
MDS or myelodysplastic syndrome is bone marrow failure and in a minority cases, turns into an acute leukemia.
It is not an uncommon complication of CLL, both, as Dr. Steensma explains, secondary to the genetic and epigenetic changes inherent in the disease itself, and to the treatments, especially the alkylating agents that damage the DNA. In CLL, these included chlorambucil (Leukeran), cyclophosphamide (Cytoxan or the C in FCR), and bendamustine (Treanda).
This is a strong argument for younger patients to avoid those drugs known to damage the bone marrow, but Dr. Steensma offers some more subtle analysis and advice.
We also discuss the radiation risk of MDS from all those CT scans we get in clinical trials.
A good friend of mine is now more than two years out post transplant at MDACC for his CLL/MDS combo one-two knockout punch and he is doing great with no molecular evidence of either disease (MRD negative). And very little graft versus disease. You can read his story at this link.
This is my last video interview from ASH 2012, but ASCO is just around the corner with more news and interviews.
Dr. Steensma clarifies and explains the risk of MDS in simple terms.
Einstein is quoted as saying: "Make things as simple as possible, but not simpler."
Dr. Steensma does exactly that.
Labels: alkylating agents, ASH 2012, bendamustine, chemotherapy, chlorambucil, Chronic lymphocytic leukemia, CLL, CT scan, cyclophosphamide, interviews, MDS, Mylelodysplastic syndrome, Radiation, Video