New options in the treatment of myelodysplastic syndrome

Myelodysplastic syndrome (MDS) is a heterogeneous group of progressive chronic hematopoietic disorders, usually presenting as refractory anemia or cytopenia, with an approximately 25% risk of progression toward acute myeloid leukaeima (AML), and no proven curative treatment. Novel biological treatment strategies targeting both the malignant blood cell and its microenvironment can overcome resistance to current therapies, and represent a promising treatment paradigm for improving patient outcome. Many of these agents have multiple biologic activities. The objective of this article is to present a comparative review of classification systems in MDS and to discuss the evolving trends in the treatment of MDS (immunosuppresive therapy, immunomodulatory drugs, arsenic trioxide, proteasome inhibitors, epigenetic therapy).