ABSTRACT
The Relevance of Myelodysplastic Syndromes in the Elderly Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematopoietic stem cell diseases characterized by a dysplastic and ineffective hematopoiesis. The clinical course is highly variable, ranging from mild symptoms caused by anemia, thrombocytopenia, or granulocytopenia to the transition to overt acute myeloid leukemia (AML). MDS are preferentially diagnosed in the elderly. The median age at diagnosis is 70þ in epidemiological studies (72 years in the Düsseldorf registry, 76 in the Tyrol registry, and 74 in the European Leukemia Net registry). The incidence of MDS increases dramatically with advanced age, revealing age-specific incidences of 9/100,000/yr, 25/100,000/yr, and 31/100,000/yr for the age groups 60 to 70, 71 to 80, and 80þ, respectively. Moreover, therapy-related MDS (t-MDS) is observed preferentially in elderly cancer survivors following successful cytotoxic chemotherapy and/ or radiation therapy. The large and increasing proportion of elderly MDS patients and the availability of more and more treatment options impose an urgent need to develop strategies and algorithms for optimal management and treatment.
