TY - CHAP M1 - Book, Section TI - Myelodysplastic Syndromes: The MD Anderson Cancer Center Approach A1 - Chien, Kelly A1 - Bueso-Ramos, Carlos A1 - Garcia-Manero, Guillermo A2 - Kantarjian, Hagop M. A2 - Wolff, Robert A. A2 - Rieber, Alyssa G. PY - 2022 T2 - The MD Anderson Manual of Medical Oncology, 4e 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. SN - PB - McGraw Hill Education CY - New York, NY Y2 - 2024/11/01 UR - hemonc.mhmedical.com/content.aspx?aid=1190832309 ER -