Lowintensity Therapy

Low-intensity therapies include hematopoietic growth factors (such as recombinant erythropoietin), immunosuppressive therapy (IST), hypomethylating agents (5-azacytadine and decitabine, though only in specific subsets of early MDS patients), and antiangio-genic/immunomodulatory agents (such as thalidomide or lenalidomide). They may be administered as standard care, when appropriate, or in the context of a clinical trial. For patients with IPSS low or intermedi-ate-1 risk disease, these treatments may be used before or concomitant with supportive care measures, or when supportive care measures are no longer effective or interfere significantly with a patient's QOL (e.g., due to frequent transfusions, infections). Low-intensity therapy may also be used for higher risk patients who are elderly or have significant comorbid conditions that prevent them from receiving higher intensity therapies, or at times used in preparation for such high-intensity treatment.

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