Update on MDS therapy: from famine to feast.

Myelodysplastic syndromes (MDS) are acquired hematopoietic stem cell disorders characterized by ineffective hematopoiesis, cellular dysfunction and increased risks of transformation into acute myeloid leukemia. The natural history of the disease remains variable and depend upon multiple prognostic factors at the time of initial diagnosis. The current prognostic models are helpful to determine the outcome of individual patients but they remain imperfect. Earlier, the most frequent treatment given for patients with MDS was supportive with transfusion of blood products and administration of erythropoietic stimulating agents and iron chelation therapy. Now, there is an arsenal of therapies available and the landscape for the treatment of MDS is rapidly evolving. There are several FDA approved therapies available for this disorder that makes this review particularly timely and relevant.