Myelodysplastic syndromes (MDS) are a heterogenous group of clonal myeloid neoplasms that are characterized by cytopenia, hematopoietic cells dysplasia and clonal hematopoiesis. Nowadays, flow cytometry (FCM) and next generation sequencing (NGS) have been added as a recommended tool for diagnostic purposes in MDS. Recently, several potential pre-MDS diseases have been proposed, including aging related clonal hematopoiesis (ARCH), clonal cytopenia of unknown significance (CCUS) and clonal hematopoiesis with high oncogenic potential (CHOP). And then, more and more patients are referred in whom a potential pre-phase of MDS are diagnosed, but definitive criteria of MDS are not fulfilled. It is probable that a practical individualized treatment approach for patients with MDS could be developed with the incorporation of comorbidity, patients′ frailty and gene mutations into existing prognostic score systems in the near future.
