Treatment for myelodysplastic syndrome: with a focus on the low-risk group

Myelodysplastic syndrome (MDS) is a group of clonal disorders affecting hematopoietic stem cells. Thus, the only potential curative therapy is hematopoietic stem cell transplantation (HSCT). Indeed, for high-risk patients with MDS, who have a higher anticipated risk of leukemic transformation and shorter survival, HSCT is the first choice for eligible patients. DNA hypomethylating agents, the only agents proved to prolong survival, are used in non-HSCT-eligible high-risk patients with MDS. In contrast, due to high transplant-related mortality rate, treatment strategies other than HSCT are mainly applied for the low-risk group with expected long-term survival. Lately, treatment options, including the progress of supportive therapy, for low-risk patients with MDS have increased. The availability of the treatment options that enhance QOL and prolong survival is the need of the present time. This review will discuss the outline of such treatment strategies, especially for low-risk patients with MDS.