Myelodysplastic Syndrome and Histone Deacetylase Inhibitors: “To Be or Not to Be Acetylated”?

Table 1

Therapeutic strategies in MDS depending of risk stratifying (adapted from [59, 60]).

	Low-risk MDS	High-risk MDS
Survival	3–10 years	<1.5 years
Risk of AML transformation	Low rate	High rate
WHO entities	RA, RARS, RCUD, RCMD, MDS-U, MDS del(5q)	RAEB (−1, −2)
IPSS Score (see [12])	Low, Int-1 (score 0-1.0)	Int-2, high (score ≥ 1.5)
Approved and applied drugs/therapies	Growth factors: Erythropoietin, G-CSF	Decitabine, 5-azacitidine
	Immune therapy: steroids, cyclosporin, antithymocyte globulin	Investigational
	Lenalidomide: 5q31	Intensive chemotherapy
	Decitabine, 5-azacitidine	(Younger, karyotype diploid), allogeneic stem cell transplantation
	Iron chelation	Iron chelation
	Translocation (5;12) or 5q23	Translocation (5;12) or 5q23
	variant (PDGFR-B): Imatinib	variant (PDGFR-B): Imatinib
Future therapeutic perspectives	Combination with specific HDAC-Inhibitors

Abbrevations. AML: acute myeloid leukaemia; G-CSF: granulocyte-colony-stimulating factor; IPSS: International Prognostic Scoring System; MDS-U: MDS unclassifiable; MDS del(5q): MDS associated with isolated deletion of chromosome 5q; PDGFR-B: platelet-derived growth factor receptor B; RA: refractory anemia; RAEB: RA with excess blasts; RARS: RA with ring sideroblasts; RCMD: refractory cytopenia with multilineage dysplasia; RCUD: refractory cytopenia with unilinease dysplasia.