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The development and institution of a therapeutic program by the Brazilian Pediatric Myelodysplastic Syndrome Co-operative Group

The management of Myelodysplastic Syndrome (MDS) in childhood is still a matter of debate and controversy. The historic relationship of this illness in children with MDS in adulthood delayed development in different areas, where perhaps knowledge related to treatment was the most affected. Due to the clonal origin of this illness, it is thought that it is virtually incurable with conventional therapies. There have been plenty of studies related to hematopoetic stem-cell transplantation with some promising results. The Brazilian Pediatric Myelodysplastic Cooperative Group (GCB-SMD-PED) was created in 1997, with the aim of studying this disease in the Brazilian population and its different aspects, whether clinical, epidemiological, cytological, pathological, cytogenetical or molecular. After five years of activities, the Co-operative Group has initiated discussions to propose therapeutic protocols for children. For this, as an initial step, a review of publications was performed about this subject, which is discussed in this article. The group also analysed the overall survival of patients referred to the Bra-PMD-CG and the different diagnostic and treatment schedules employed in each institution, varying from simply conservative treatment, palliative measures, blood transfusions to bone marrow transplantation. The authors describe the different ways used for MDS treatment in childhood, as well as the rationale employed of each therapeutic modality and the studies related to this area.

Myelodysplastic Syndrome; treatment; pediatrics


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