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In some cases where investigational therapy is unavailable, palliative care may be the best option. Like AML, myelodysplastic syndrome (MDS) is a disease of the elderly. It is divided into higher and lower risk groups. The natural history of high-risk MDS (eg, &gt; 10% marrow blasts) bears more resemblance to that of AML than to that of an indolent disorder; accordingly, similar therapeutic considerations apply. The more benign natural history of lower risk MDS leads to consideration of reduction in transfusion needs and improvement in quality of life as primary goals of therapy. Lenalidomide, azacitidine, and decitabine, each recently approved by the US Food and Drug Administration, are useful in achieving these objectives. <\/jats:p>","DOI":"10.1200\/jco.2006.10.2731","type":"journal-article","created":{"date-parts":[[2007,5,8]],"date-time":"2007-05-08T22:17:58Z","timestamp":1178662678000},"page":"1908-1915","source":"Crossref","is-referenced-by-count":194,"title":["Acute Myeloid Leukemia and Myelodysplastic Syndromes in Older Patients"],"prefix":"10.1200","volume":"25","author":[{"given":"Elihu","family":"Estey","sequence":"first","affiliation":[{"name":"From the Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.13.3575"},{"key":"R2","unstructured":"Thall P, Estey E: Graphical methods for evaluating covariate effects in the Cox model, in Crowley J (ed): Handbook of Statistics in Clinical Oncology . 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