Myelodysplastic syndromes

These suggested practice guidelines are based on extensive evaluation of reviewed risk-based data and indicate useful current approaches for managing patients with MDS. The FDA recently approved 4 drugs for treating specific subtypes of MDS: lenalidomide for MDS patients with del(5q) cytogenetic, abnormalities; azacytidine and decitabine for treating higher-risk or nonresponsive MDS patients; and deferasirox for iron chelation of MDS patients with iron overload. However, because a substantial proportion of MDS patient subsets lack effective treatment for their cytopenias or for altering disease natural history, clinical trials with these and other novel therapeutic agents along with supportive care remain the hallmark of management for this disease. The role of thrombopoietic cytokines in managing thrombocytopenia in MDS requires fiirther evaluation. In addition, further determination of the effects of these therapeutic interventions on patient QOL is important.^{97,100,101,109,110} Progress toward improving management of MDS has occurred over the past few years and more advances are anticipated using these guidelines as a framework for coordinating comparative clinical trials.