[Complete diagnostic work-up provides the rational basis for the most appropriate therapy of myelodysplastic syndromes]

Myelodysplastic syndromes are now classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires a keen evaluation of disease-related factors to adapt treatment to patients age, expectations and comorbidities. A high proportion of MDS patients are not eligible for potentially curative and consequently intensive treatment because of advanced age and/or clinically relevant comorbidities and poor performance status. In these patients, a number of new agents are available or being developed but their use should be carefully guided by the chromosomal and genetic determinant of the disease.