[Current treatment strategies for myelodysplastic syndromes]

Myelodysplastic syndromes (MDS) are myeloid clonal disorders presumably induced by genetic mutations in immature hematopoietic cells. According to the international prognostic scoring system (IPSS or IPSS-R), patients are classified into two groups: lower-risk MDS (LR-MDS) and higher-risk MDS (HR-MDS). A majority of LR-MDS patients manifest refractory cytopenias due to inefficient hematopoiesis, and patients in this group are principally treated with agents stimulating hematopoiesis or differentiation. On the other hand, patients with HR-MDS are at much higher risk of developing leukemia, and thus require prompt hematopoietic stem cell transplantation or chemotherapy. In this section, I will discuss current treatment strategies for MDS in Japan, including future perspectives.