Blood & Cancer

Treatment strategies for myelodysplastic syndromes (MDS) vary widely depending upon patients’ prognosis. In this episode, Shannon R. McCurdy, MD, of the University of Pennsylvania, Philadelphia, joined host David H. Henry, MD, to discuss how she treats patients with MDS. To start, Dr. McCurdy evaluates patients using the revised International Prognostic Survival Scale (IPSS-R), which can predict the aggressiveness of MDS. Low IPSS-R scores (6) are associated with high-risk MDS, which has a median survival of 0.8 years. Dr. McCurdy also performs molecular testing to assess risk. A poor-risk molecular profile can increase the IPSS-R by 1 point, she said. Dr. McCurdy went on to explain how she approaches treatment according to risk. Asymptomatic, low-risk MDS Monitor patients’ complete blood count, typically every 3-6 months, and intervene if there is progression. Low-risk patients who require treatment Those who have deletion 5q with anemia should receive lenalidomide first. Patients without 5q deletion a