RT Book, Section A1 Chien, Kelly A1 Bueso-Ramos, Carlos A1 Garcia-Manero, Guillermo A2 Kantarjian, Hagop M. A2 Wolff, Robert A. A2 Rieber, Alyssa G. SR Print(0) ID 1190832309 T1 Myelodysplastic Syndromes: The MD Anderson Cancer Center Approach T2 The MD Anderson Manual of Medical Oncology, 4e YR 2022 FD 2022 PB McGraw Hill Education PP New York, NY SN 9781260467642 LK accessmedicine.mhmedical.com/content.aspx?aid=1190832309 RD 2024/03/29 AB KEY CONCEPTSThe term myelodysplastic syndrome(MDS) refers to a very heterogeneous group of myeloid disorders. In a majority of patients, MDS results from defects in a primitive hematopoietic stem cell compartment.Individuals with evidence of clonal hematopoiesis are at increased risk of developing MDS.Prognosis is calculated using a number of variables, including degree of cytopenia, percentage of blasts, cytogenetic alterations, and more recently genomic annotation.Using either the International Prognostic Scoring System or the Revised International Prognostic Scoring System, patients are divided into those with lower and higher risk disease.For patients with lower-risk disease, treatment approaches include growth factors, iron chelation, luspatercept, lenalidomide (for del5q- MDS), hypomethylating agents (HMAs; azacitidine or decitabine) or antithymocyte globulin–-based therapy (for patients with hypoplastic MDS). Allogeneic stem cell transplantation (allo-SCT) is reserved for younger patients with poor risk features.For patients with higher risk disease, the main treatment options include the HMAs and less frequently acute myeloid leukemia–like therapy. Allo-SCT should be considered in candidate patients early in the course of the disease in responding patients. Clinical trials should be considered for a majority of patients with MDS.