There are newer prognostic scoring systems for MDS and a lot of the trials because of when they were designed they tend to get designed, you know, a few years before they actually finish completion if not sometimes even like five or more years. There’s newer prognostic scoring systems that now incorporate molecular mutations into the prognostic score. I think it’s very important for MDS doctors to do that because if you are higher risk or what we call upstaged from the older prognostic scoring systems into the IPSS-M scoring system, then I would probably refer them to a more specialized leukemia center because one could consider or they can be considered for a transplant for a curative potential...
There are newer prognostic scoring systems for MDS and a lot of the trials because of when they were designed they tend to get designed, you know, a few years before they actually finish completion if not sometimes even like five or more years. There’s newer prognostic scoring systems that now incorporate molecular mutations into the prognostic score. I think it’s very important for MDS doctors to do that because if you are higher risk or what we call upstaged from the older prognostic scoring systems into the IPSS-M scoring system, then I would probably refer them to a more specialized leukemia center because one could consider or they can be considered for a transplant for a curative potential. So that’s probably one of them. And also there are quite a few, despite the new agents that we have and also agents that are coming out on trial for lower risk MDS, sometimes patients still remain transfusion dependent. And if so, because of the ongoing risk of iron overload, I think that they have to be referred as well to specialized centers because again they might warrant a bit more intensive treatment, for example, have the discussion about transplants as well.
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