Myelodysplastic syndromes
Clonal cytopenias of older adults, the mimics to exclude first (B12, copper, alcohol, drugs), WHO 2022 and ICC classification, IPSS-R and IPSS-M risk, treating lower-risk disease for cytopenias (ESA, luspatercept, lenalidomide for del(5q)), and azacitidine or transplant for higher-risk disease.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Clonal myeloid neoplasms with ineffective haematopoiesis: cytopenias, dysplasia and a risk of progression to AML (about a third overall).
- Median age at diagnosis is over 70. Most present with macrocytic anaemia found on routine bloods.
- Exclude mimics first. Deficiencies, alcohol and drugs cause dysplasia too.
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Sources
- Myelodysplastic syndromes: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upFenaux P et al., Ann Oncol 2021;32:142-56, 2021
- NCCN Guidelines Insights: Myelodysplastic Syndromes, Version 2.2025Greenberg PL et al., J Natl Compr Canc Netw 2025, 2025
- Molecular International Prognostic Scoring System for myelodysplastic syndromesBernard E et al., NEJM Evidence 2022;1:EVIDoa2200008, 2022
- Optimal care pathway for people with myelodysplastic syndrome, 1st editionAU/NZCancer Council Australia
- Schedule of Pharmaceutical Benefits, November 2026 (azacitidine)AU/NZAustralian Government Department of Health, Disability and Ageing, 1 November 2026
- Luspatercept versus epoetin alfa in ESA-naive, transfusion-dependent, lower-risk myelodysplastic syndromes (COMMANDS): primary analysisDella Porta MG et al., Lancet Haematol 2024;11:e646-58, 2024
- Last updated
- 14 November 2026
What changed
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