Retuning the immune system in myelodysplastic syndromes: from immunomodulatory approaches to vaccination strategies and non myeloablative hemopoietic cell transplant

Crit Rev Oncol Hematol. 2019 Jan:133:112-119. doi: 10.1016/j.critrevonc.2018.11.001. Epub 2018 Nov 16.


Several findings suggest that the pathogenesis and clinical history of myelodysplastic syndromes (MDS) is influenced by a variety of immune pathways and mechanisms. Coherently several therapeutic approaches based on the idea of modulating the immune system have been exploited in this clinical setting. The present review will first consider more consolidated strategies such as antithymocyte globulin and immunomodulatory (IMiDs) analogues. Less explored approaches, such as anti tumor necrosis factor antibodies, cyclosporin and bortezomib will be also evaluated. Finally the potential impact of anti-tumour vaccination or hemopoietic cell transplantation on the outcome of MDS patients will be addressed.

Keywords: Autoimmune manifestations; Autoimmunity; Immunotherapy; Myelodysplastic syndromes.

Publication types

  • Review

MeSH terms

  • Cancer Vaccines / therapeutic use
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Immune System / drug effects
  • Immune System / physiopathology*
  • Immunomodulation / physiology*
  • Myeloablative Agonists / adverse effects
  • Myelodysplastic Syndromes / immunology*
  • Myelodysplastic Syndromes / therapy*
  • Transplantation Conditioning / adverse effects
  • Transplantation Conditioning / methods
  • Vaccination / methods*


  • Cancer Vaccines
  • Myeloablative Agonists