Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis with blood cytopenias, morphological dysplasia and has tendency to progress into AML. MDS is regarded as the most prevalent form of acquired bone marrow failure syndrome in older adults > 65years of age and more common in men than in women. The current 2022 WHO classification introduces the term myelodysplastic neoplasms (abbreviated MDS) to replace myelodysplastic syndromes. The cause of MDS still remain unknown, however the etiology can be categorized into MDS arise without any underlying cause as de novo in older patients, or with underlying cause as secondary MDS.
The hallmark of MDS pathogenesis is dysregulated hematopoietic differentiation which result in impaired differentiation, morphological dysplasia, and cytopenia, and all of these are due to complex interplay between genetic and epigenetic alterations, bone marrow microenvironment, and the immune system. Therapeutic options for adult patients with MDS vary from supportive care to allo-HCT.