Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 625

In lower‐risk MDS (PSS low/intermediate‐1, IPSS‐R very low, low, intermediate up to 3.5 points), goals of care are improvement of cytopenias, prevention of possible related complication (bleeding, infections), lowering the transfusion burden, and conservation of quality of life. In many older adults with mild and asymptomatic cytopenias, or in those with reduced life expectancy, watchful waiting is a reasonable option. An intensified surveillance program should be pursued for patients with higher‐risk genetic profile, especially those who are fit based on CGA and would be suitable for more intensive treatment strategies. During follow‐up, worsening of cytopenias and increasing number of blasts (either circulating or bone marrow) should prompt a re‐evaluation of the disease management plan.