The point on myelodysplastic syndromes

The Myelodysplastic Syndromes (MDS) are heterogeneous borderline diseases, with propensity to transform into acute leukemia. Some paradoxes need more attention either in experimental and clinical approach: the clonal proliferation, involving all the hematopoietic lines, but associated with a relatively long evolution which ends not always into acute leukemia; involvement of cytokines, but a poor therapeutical response to anti-cytokine therapy; the surprisingly good effect of the "differentiating "drugs in vitro and the poor response in vivo. The prognostic scores according to cytological, histological and genetic criteria, and the therapeutical approach are discussed.