Myelodysplastic syndromes (MDS) represent a group of myeloid clonal hemopathies with heterogeneous clinical manifestations. The main clinical complication in MDS is morbidity due to cytopenias and the potential to progress into acute myeloid leukemia (AML). Unfortunately, approximately 30% of patients will eventually develop leukemia, and even in those who do not, prognosis is extremely poor. Prognosis is based on the International Prognostic Scoring System (IPSS) or the Revised International Prognostic Scoring System (IPSS-R), which define 5 groups of patients with varying risks of developing leukemia and projected survival duration. In addition to this risk-based evaluation, initial therapeutic interventions for MDS are determined based on patient age, comorbidities, performance status, and quality of life. Treatment options for MDS are limited; the only cure is allogeneic bone marrow transplant, and this may not be appropriate for elderly patients. Other approved treatment options for MDS include hypomethylating agents, azacitidine and decitabine, and an immunomodulator agent, lenalidomide. In addition, several investigational agents are in clinical trials.
This activity will focus on how to accurately risk stratify patients with MDS, the efficacy and safety of current agents, how and when to initiate treatment, new treatment strategies, and how to best improve patient outcomes by implementing these strategies for the treatment of low- and high-risk MDS patients.