Guidelines for the diagnosis and treatment of the myelodysplastic syndromes

The myelodysplastic syndromes (MDS) encompass a heterogeneous group of malignant bone marrow diseases characterized by ineffective, dysplastic hematopoiesis with subsequent pancytopenia, and an increased risk for developing acute myeloid leukemia (AML). There is a vast variation in symptoms and prognosis. While some patients may live for decades with mild asymptomatic anemia, others present with profound pancytopenia and rapid progression towards AML. Several potential therapeutic options for MDS have been evaluated in clinical trials, but the majority of these have shown only moderate efficacy. Moreover, there are relatively few randomized controlled trials to support decision-making for the individual patient.