[Perspective on the treatment of myelodysplastic syndromes]

The myelodysplastic syndromes (MDS) are acquired bone marrow disorders characterized by therapy-resistant cytopenias as a result of ineffective hematopoiesis and by preleukemic states. Diagnosis of MDS is done by clinical manifestations and hematological findings mainly according to the 4th WHO classification, but as it is sometimes difficult to discriminate MDS from other hematological diseases, a guideline for morphological evaluation is proposed. International Prognostic Scoring System is useful for choice of the treatment but this system is now under revision. Although most patients are fatal except the cases who receive successful stem cell transplantation, promising therapeutic drugs such as DNA hypomethylating agents and lenalidomide are developed and may alter the prognosis and quality of life of the patients suffering from MDS.