Therapeutic possibilities in the treatment of the myelodysplasia syndrome

: Myelodysplastic syndromes are clonal haemopoietic stem-cell disorders often associated with peripheral cytopenia due to the ineffective haemopoiesis and, there is a risk of transformation to overt acute leukaemia. Purpose of the therapy of various myelodysplastic syndromes is to reduce the severity of peripheral cytopenia with correction of ineffective haemopoiesis and, elimination of the aberrant haemopoietic clon. No standard treatment can be recommended for patients with myelodysplasia. Most of older patients without an excess of blasts of bone marrow are carefully monitored, and cytopenia may be corrected by administration of blood components. In myelodysplastic syndromes characterized with an excess of blasts low-dose Ara-C therapy or an "agressive" antileukemical chemotherapy may be used in younger patients. Selected patients may be cured by HLA-identical allogeneic bone marrow transplantation. Authors discuss the effect of various therapeutic procedures is myelodysplastic syndromes on the basis of clinical experiences and review their own observations from the application of small dose Ara-C.