Treatment of Higher-Risk Myelodysplastic Syndrome (IPSS-R ≥4.0) When Allogeneic Stem Cell Transplantation Is Not Immediately an Option

This protocol applies to higher-risk MDS with an IPSS-R score of 4.0 or above in patients without major comorbidities who are not immediately eligible for allogeneic stem cell transplantation — particularly those older than 70 years or with an unfavourable karyotype.

Clinical Scenario

Myelodysplastic syndrome, higher-risk (IPSS-R 4.0 or higher), no major comorbidities, not immediately eligible for allo-SCT, and either older than 70 years or presenting with an unfavourable karyotype.

Treatment Approach

A hypomethylating agent — specifically azacitidine — is the recommended first-line treatment for this patient population. The complete dosing schedule, number of cycles, and clinical guidance for patient-specific adjustments are detailed in the full protocol.

Full regimen, schedule, and evidence grading available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

In patients with higher-risk MDS without major comorbidities who are not immediately eligible for allo-SCT, azacitidine is recommended [I, A].

DOI: 10.1016/j.annonc.2020.11.002

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