The role of hypomethylating agents prior to hematopoietic cell transplantation in myelodysplastic syndromes.

Therapies for myelodysplastic syndromes (MDS) are chosen depending on whether a patient has lower- or higher-risk disease. Hypomethylating agents are recommended as up-front therapy for all higher-risk patients, and lower-risk patients with multiple cytopenias. This article reviews the rationale for hypomethylating agents, their use or intensive chemotherapy pre-transplant, and data supporting pre-transplant MDS treatment.