Myelodysplastic Syndromes

Myelodysplastic syndromes (MDSs) refer to a group of hematopoietic disorders characterized by ineffective hematopoiesis and an increased risk of transformation to acute myelogenous leukemia. The median age of patients with MDS is 70-75 years, and it is likely that environmental factors play an important role in the pathogenesis of this disease. MDS is classified according to the WHO criteria, and a number of prognostic scores are in place to predict the natural history of patients affected by these disorders. Cytogenetic alterations, in particular affecting chromosome 5 and 7 are frequent in MDS and predict for distinct prognoses. Over the last decade, we have witnessed significant improvement in supportive care and therapeutic modalities for patients with MDS. These include growth factors, immune modulatory agents, such as lenalidomide, and hypomethylating agents including 5-azacitidine and decitabine. In this chapter, we summarize recent advances in our knowledge of MDS.