This chapter discusses myelodysplastic syndromes (MDS), which are a spectrum of pre-leukaemic disorders that manifest in the elderly and can have a prolonged course. Patients afflicted with MDS require regular monitoring for evidence of disease progression, infections, and cytopenias that may be alleviated through proper treatment. Decision and administration of interventions such as high-dose chemotherapy or bone marrow transplantation should be guided by the IPSS scoring system. In younger patients, the timing of the administration of such interventions should involve a delicate balance between the risk of progression and their current life situation. In adults, meanwhile, palliation of symptoms and appropriate supportive care should be given more attention, as intensive interventions are not appropriate due to their medical conditions and performance status. In addition to discussing the pathology and aetiology of MDS, the chapter also discusses the classification of MDS, such as the FAB and WHO classifications; the overlapping features of MDS syndromes with other stem cell disorders; and the prognostic factors of MDS.
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