Recent Developments and Challenges in the Treatment of Acute Leukemia and Myelodysplastic Syndromes: A Systematic Review.
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The diagnosis of acute leukemia (AL) and myelodysplastic syndrome (MDS) is critical due to their rapid progression and varied survival rates between children and older adults. These diseases are associated with significant mortality, highlighting the need for strategies to reduce the global burden of AL and MDS. Their direct involvement with the blood, bone marrow, and extramedullary sites complicates treatment management. However, recent therapeutic advancements offer hope for the long-term management of AL and MDS. This systematic review followed the guidelines put forth by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to assess recent developments and challenges in the treatment of AL (including acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL)) and MDS. Databases such as PubMed, Google Scholar, NCBI, Scopus, Blood Journal, Cochrane Library, and Leukemia Gene Atlas (LGA) were used to retrieve articles published from 2017 to 2024, with the last search conducted in August 2024. A total of 12 peer-reviewed studies were selected based on specific inclusion and exclusion criteria. These studies reveal advancements in the diagnosis, classification, and treatment of AL and MDS, including long-term disease-free survival, complete remissions, and improved patient outcomes in those over 75 years of age. Less toxic treatment methods, such as targeted therapies, immunotherapies, and bispecific T-cell engagers, are particularly beneficial for older adults with ALL. Significant progress has also been made in understanding the genetic mutations in AML, leading to more personalized therapies. In MDS, a combination of chemotherapy, immunosuppressive treatments, targeted therapies, and stem cell transplants has shown high efficacy. However, challenges remain, including high initial treatment costs, limited patient access, inadequate awareness, insufficient employee training, and the lack of accurate treatment models. Despite these hurdles, these advances provide promising options for improving the quality of life for patients with AL and MDS.