Table 1. Goals of care and treatment... | American Society of Hematology

Table 1.

Goals of care and treatment approaches according to medical fitness in older patients with HR-MDS

Medical fitness*	Goals of care	First-choice treatment	Alternative option
Fit	Achieve long-term survival with the possibility of cure	HSCT	HMA
			ICT
			Clinical trial
Intermediate fitness†	Alleviate symptoms, improve quality of life, and/or prolong life.	HMA	Clinical trial
Frail	Palliation	Supportive care	Clinical trial (?)

Medical fitness*	Goals of care	First-choice treatment	Alternative option
Fit	Achieve long-term survival with the possibility of cure	HSCT	HMA
			ICT
			Clinical trial
Intermediate fitness†	Alleviate symptoms, improve quality of life, and/or prolong life.	HMA	Clinical trial
Frail	Palliation	Supportive care	Clinical trial (?)

Fit: ECOG PS 0 or 1 and HCT-CI 0; intermediate fitness: ECOG PS 2 or HCT-CI 1 or 2 or SPPB score 9; frail: ECOG PS ≥ 3 or HCT-CI ≥ 3 or SPPB score < 9.

†

Some intermediate fitness patients could be offered allogeneic HSCT with reduced intensity conditioning.

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