The myelodysplastic syndromes (MDS) represent myeloid clonal hemopathies with relatively heterogeneous spectrums of presentation. The major clinical problems in these disorders are morbidities caused by patients' cytopenias and the potential for MDS to evolve into acute myeloid leukemia (AML). Managing MDS is complicated by the generally advanced age of the patients (median ages range from 65–70 years), the attendant non-hematologic comorbidities, and older patients' relative inability to tolerate certain intensive forms of therapy. In addition, when the illness progresses into AML, these patients experience lower response rates to standard therapy than patients with de novo AML.
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