Why the stagnation in effective therapy for MDS?

The question posed above assumes that we are going nowhere in therapies for myelodysplastic syndromes (MDS) and asks, why? Yet, in recent years novel and effective therapies for MDS indeed have begun to emerge, particularly in patients with lower-risk disease. Beyond this, however, most of the progress has been limited to advances in allogeneic transplantation for higher-risk patients. This discussion will focus first on areas where we have moved beyond "stagnation," including these advances in supportive care for lower-risk patients and in emerging transplant gains. Further, in areas that have not seen the same encouraging advances, suggestions are made on how to move the field forward. The promise for the future lies in finding more creative ways to partner molecular genetics, novel drugs, and novel clinical trial designs.