Table 3.

Algorithm for treating symptomatic patients with low and intermediate-1 risk myelodysplastic syndrome (MDS).

Abbreviations: FAB, French-American-British; WHO, World Health Organization; Epo, erythropoietin; G-CSF, granulocyte colony-stimulating factor 

  • High-quality transfusion and chelation therapy

  • Evaluate refractory anemia (FAB or WHO) for immunosuppressive treatment

  • Evaluate for curative approaches; allogeneic stem cell transplantation (intermediate-1 risk)

  • Patients with 5q– aberration: lenalidomide if available

  • Epo ± G-CSF according to decision model (only good and intermediate probability of response). Start with Epo, add G-CSF at 8 weeks if no response

  • Other patients, and patients with no or lost response to treatment above: clinical trials/transfusion therapy/hypomethylating agents, if available

 
Abbreviations: FAB, French-American-British; WHO, World Health Organization; Epo, erythropoietin; G-CSF, granulocyte colony-stimulating factor 

  • High-quality transfusion and chelation therapy

  • Evaluate refractory anemia (FAB or WHO) for immunosuppressive treatment

  • Evaluate for curative approaches; allogeneic stem cell transplantation (intermediate-1 risk)

  • Patients with 5q– aberration: lenalidomide if available

  • Epo ± G-CSF according to decision model (only good and intermediate probability of response). Start with Epo, add G-CSF at 8 weeks if no response

  • Other patients, and patients with no or lost response to treatment above: clinical trials/transfusion therapy/hypomethylating agents, if available

 
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