Longevity & AgingMyelodysplastic Syndromes in 2026 Brings New Options for Anemia and Risk Scoring
Myelodysplastic syndromes (MDS) are blood cancers of older adults that cause low blood counts and can progress to acute myeloid leukemia. This 2026 expert update reviews how MDS is diagnosed, how risk is scored, and how treatment is chosen. Diagnosis rests on bone marrow dysplasia, supported by cytogenetics and gene sequencing. The molecular IPSS-M adds mutation data to the older IPSS-R. For lower-risk disease with transfusion-dependent anemia, the COMMANDS trial showed luspatercept beat epoetin alfa (60.4% vs 34.8% response), and the author now favors it first-line. Imetelstat is an option after ESA failure. Clonal hematopoiesis (CHIP/CCUS) should be monitored, not treated. Allogeneic transplant remains the only cure, and no approved options exist after hypomethylating agent failure.
