Transfusion dependent MDS patients have worse prognosis compared to transfusion independent patients. Iron overload associated with transfusion dependence contributes to worse prognosis. Low risk patients are often treated with Erythropoietin, Luspatercept can considered for patients with ring sideroblasts while high risk patients are treated with Hypomethylating agents. Lenalidomide is particularly useful for patients with Del 5-q abnormality.
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