NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Myelodysplastic Syndromes

NCCN All recommendations are category 2A unless otherwise specified. See believes that the best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged. NCCN To find clinical trials online at NCCN Member Institutions, click here: nccn.org/clinical_trials/physician.html. The NCCN Guidelines are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult the NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network (NCCN) makes no representations or warranties of any kind regarding their content, use or application and disclaims any responsibility for their application or use in any way. The NCCN Guidelines are copyrighted by National Comprehensive Cancer Network. All rights reserved. The NCCN Guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN. ©2013. Classification of MDS tables. Added " Refractory anemia with excess blasts in transformation (RAEB-T) to the table with footnote " l ". Footnote l: (aspirate smears preferred) should be reported. Flow cytometric est " In the 2008 WHO classification, RAEB-T (as previously classified by the FAB group, Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the myelodysplastic syndromes. Br J Haematol 1982;51:189-199) is classified as AML with myelodysplasia-related changes and may be more akin to MDS than AML. Modified footnote " p " : " Examples include thrombocytosis, leukocytosis, and splenomegaly. In addition, RARS-T has been suggested as a provisional entity for individuals with RARS and platelet counts 450,000 x10 /L. · Added clone positivity. " " IPSS-R: Very Low, Low, Intermediate " to the heading. Following " Clinically significant cytopenia(s) " added " or increased marrow blasts. " Following " Clinically relevant thrombocytopenia or neutropenia " added " or increased marrow blasts. " Changed " No response " to " Disease progression/no response. " Added footnote " bb " : " IPSS-R Intermediate patients may be managed as very low/low risk or high/very high risk depending upon additional prognostic factors such as age, performance status, serum ferritin levels, and serum LDH levels. If patients initially are managed as lower risk but fail to respond, move to higher risk management strategies. " Moved " Footnote " ee " has been modified: …