Treatment of higher-risk myelodysplastic syndrome.

The myelodysplastic syndromes (MDS) are divided into lower-risk and higher-risk categories. This differentiation is important for treatment selection. Over the last decade, we have witnessed significant improvements in the treatment of patients with higher-risk MDS that have resulted in improved survival with the hypomethylating agent 5-azacytidine This has resulted in a shift from the use of acute myelogenous leukemia (AML)-like therapies, which were traditionally offered to this group of patients in the past, to the hypomethylating agents, which have become the standard of care. Despite these advances, new therapies or combinations are needed to improve response and survival rates. This review will summarize results from current available therapies and discuss potential needs and ongoing research in the area of treatment of higher-risk MDS.