[Current treatment options for lower-risk myelodysplastic neoplasms]

Lower-risk myelodysplastic neoplasms (LR-MDS) are a subset of MDS with Very Low to Intermediate risk in the revised international prognostic scoring system. The major clinical issues in patients with LR-MDS are cytopenias and blood cell dysfunction, and therapy is mainly focused on improvement of hematopoiesis. Several therapeutic options are currently available in Japan, namely, lenalidomide, erythropoiesis stimulating agents, luspatercept, immunosuppressive agents, anabolic steroids, vitamin K/D, hypomethylating agents, allogeneic hematopoietic stem cell transplantation, and iron chelating agents. However, the indications and efficacy of these treatments are generally limited, which often makes it difficult to decide on a treatment strategy. In this review, I will discuss how to treat patients with LR-MDS.