Therapeutic options for myelodysplastic syndromes (MDS) are highly risk stratified, with more toxic treatments reserved for patients at higher risk and more supportive approaches favored for those with lower-risk disease. The hypomethylating agents azacitidine (AZA) and decitabine (DEC) are recommended as first-line therapy for higher-risk MDS; for lower-risk disease, the focus is primarily on treating symptomatic anemia with hematopoietic growth factors, luspatercept, or lenalidomide.
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