Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) represent myeloid clonal hemopathies with relatively heterogeneous spectrums of presentation. The major clinical problems in these disorders are morbidities caused by patients' cytopenias and the potential for MDS to evolve into acute myeloid leukemia (AML). Managing MDS is complicated by the generally advanced age of patients, attendant non-hematologic comorbidities, and older patients' relative inability to tolerate some therapies. In addition, when the illness progresses into AML, these patients experience lower response rates to standard therapy than patients with de novo AML. Important changes from the 2008 version of the guidelines include the addition of lenalidomide as a possible treatment for symptomatically anemic non-del(5q) patients whose anemia does not respond to initial therapy. For the most recent version of the guidelines, please visit NCCN.org