Table 3.

Treatment options for various issues encountered in myelodysplastic syndrome.

Condition	Treatment
Anemia	Erythropoiesis-stimulating agents +/− granulocyte-colony stimulating factor Anabolic steroids (e.g., danazol) Lenalidomide (most effective in 5q minus syndrome) or similar agents Immunosuppressive agents DNMT inhibitors Transfusions (generally, for hematocrit <21%; for select patients, hematocrit <24%); generally, iron chelation is considered in select patients but the survival benefit has not been proven in a prospective, randomized-controlled study
Thrombocytopenia	Immunosuppressive agents Thrombopoietin receptor agonists Anabolic steroids (e.g., danazol) DNMT inhibitors Transfusions (generally, for platelet counts of less than 10,000 per microliter)
Neutropenia	G-CSF Anti-microbial prophylaxis (see below) DNMT inhibitors
Infection prevention	Prolonged severe neutropenia e.g., absolute neutrophil count of less than 500 cells per microliter expected for ≥7 days Levaquin or similar Posaconazole or similar Acyclovir (prophylaxis dose) indefinitely for periodic or prolonged neutropenia
Bleeding prevention	Anti-fibrinolytic agents (topical or systemic)
Disease-modifying therapies	DNMT inhibitors Lenalidomide or similar
Disease burden reduction	DNMT inhibitors Cytotoxic chemotherapy (usually in setting of high risk disease with excessive blasts)