Table 1.

Treatment approach in nontransplant candidates at the University of Minnesota

INT-1/low-risk IPSS

No treatment indicated → supportive measures only Symptomatic anemia If anemic + low EPO level: trial of EPO supplementation with or without G-CSF Transfusion-dependent anemia not responding to growth factors 5q–: lenalidomide Normal/other cytogenetics: order of treatment choice Azacitidine Clinical trial ATG/CSA: if younger (<60 years) or HLA DR15 Neutropenic or thrombocytopenic requiring therapy Azacitidine Clinical trial if not responding to azacitidine

INT-2/high-risk IPSS

Requiring therapy Azacitidine Clinical trial if progression on azacitidine

Abbreviations: EPO, erythropoietin; G-CSF, granulocyte-colony-stimulating factor; ATG, antithymocyte globulin; CSA, cyclosporine; HLA-DR15, human leukocyte antigen DR-15.