[Novel treatment strategies for lower-risk myelodysplastic neoplasms]

The goal of treatment for lower-risk myelodysplastic neoplasms (MDS) is to improve cytopenia, and therapeutic options should include agents with few adverse events. Since anemia is the main symptom of this disease, red blood cell transfusions, darbepoetin, anabolic steroids, and immunosuppressive agents are considered when the disease is symptomatic, but with the advent of the novel anti-anemic agent luspatercept, there is growing debate regarding the timing of therapeutic intervention and the hemoglobin (Hb) levels at which red blood cell transfusion should be considered in this disease. As a result, there is a growing debate among institutions regarding these issues. It has become clear that there are slight differences in the criteria for initiation of transfusion and the timing of therapeutic intervention with anti-anemic agents at different centers. In this review, we will discuss the extent to which therapeutic intervention for lower-risk MDS improves the quality of life (QOL) of patients and how to improve the efficiency of limited healthcare resources, including an overview of ongoing clinical trials.