Related Experiment Video
Updated: Jun 3, 2025

Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
Published on: October 3, 2018
Advancing drug development in myelodysplastic syndromes
Alain Mina1,2, Kathy L McGraw1,2,3, Lea Cunningham1,2
1Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Abstract:
Myelodysplastic syndromes/neoplasms (MDSs) are heterogeneous stem cell malignancies characterized by poor prognosis and no curative therapies outside of allogeneic hematopoietic stem cell transplantation. Despite some recent approvals by the US Food and Drug Administration, (eg, luspatercept, ivosidenib, decitabine/cedazuridine, and imetelstat), there has been little progress in the development of truly transformative therapies for the treatment of patients with MDS. Challenges to advancing drug development in MDS are multifold but may be grouped into specific categories, including criteria for risk stratification and eligibility, response definitions, time-to-event end points, transfusion end points, functional assessments, and biomarker development. Strategies to address these challenges and optimize future clinical trial design for patients with MDS are presented here.
Insights
Developing new treatments for myelodysplastic syndromes (MDS) faces challenges in clinical trials. Addressing these issues is key to advancing MDS therapies and improving patient outcomes.
Area of Science:
- Hematology
- Oncology
- Stem Cell Malignancies
Background:
- Myelodysplastic syndromes (MDS) are stem cell cancers with poor prognosis.
- Curative options are limited to stem cell transplantation.
- Recent drug approvals show modest progress, but transformative therapies are lacking.
Purpose of the Study:
- To identify and categorize challenges in MDS drug development.
- To propose strategies for optimizing clinical trial design in MDS.
- To facilitate the advancement of novel MDS therapies.
Main Methods:
- Review and categorization of existing challenges in MDS clinical trials.
- Analysis of criteria for risk stratification, eligibility, and response definitions.
- Discussion of endpoints, functional assessments, and biomarker development.
Main Results:
- Key challenges include risk stratification, response criteria, and endpoint selection.
- Biomarker development and functional assessments require optimization.
- Current trial designs face significant hurdles for drug development.
Conclusions:
- Addressing multifaceted challenges in clinical trial design is crucial for MDS.
- Optimized trial strategies are needed to accelerate the development of effective MDS therapies.
- Improved approaches will enhance therapeutic progress for MDS patients.
Related Concept Videos
Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
iPS Cell Differentiation
Differentiation of Common Myeloid Progenitor Cells

