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Allogeneic haematopoietic stem cell transplantation (allo\u2010HSCT), including haploidentical HSCT (haplo\u2010HSCT), is the only curative option. Age\u2010stratified selection of conditioning regimens based on organ reserve and comorbidity burdens has been routine clinical practice for many years. However, recent developments warrant a critical re\u2010examination: the incorporation of hypomethylating agents and targeted therapies (decitabine, venetoclax), the introduction of the quantitative Transplant Conditioning Intensity (TCI) score, and emerging data in patients aged \u2265\u00a070\u00a0years. This review summarizes age\u2010stratified regimens: myeloablative (MAC), reduced\u2010intensity (RIC), and reduced\u2010toxicity (RTC). In younger patients (&lt;\u00a050\u00a0years), MAC achieves 3\u2010year overall survival (OS)\u00a0&gt;\u00a070% and non\u2010relapse mortality (NRM)\u00a0&lt;\u00a015%. In middle\u2010aged (50\u201360\u00a0years) and elderly (&gt;\u00a060\u00a0years) patients, RIC\/RTC yield OS of 60%\u201370% with NRM &lt;\u00a020%, though these estimates derive largely from retrospective or single\u2010center studies. Adding targeted\/hypomethylating agents (e.g.,\u00a0decitabine, venetoclax) has shown promise in reducing relapse in high\u2010risk patients. Age\u2010stratified conditioning combined with these agents forms the core of individualized transplant strategies, reducing NRM and improving efficacy. Prospective, MDS\u2010specific randomized trials are urgently needed to transform these preliminary observations into evidence\u2010based standards.<\/jats:p>","DOI":"10.1002\/hon.70258","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T18:00:30Z","timestamp":1789236030000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age\u2010Stratified Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Myelodysplastic Syndromes: A Comprehensive Review"],"prefix":"10.1002","volume":"44","author":[{"given":"Ning","family":"Wu","sequence":"first","affiliation":[{"name":"Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies Peking University People's Hospital Peking University Institute of Hematology National Clinical Research Center for Hematologic Disease Peking University  Beijing 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