MDS treatment algorithms. Accurate diagnosis, disease classification (lower or higher risk) and goals of treatment are important at initial diagnosis. Once therapy is appropriate, selection of suitably intense therapies versus disease-modifying treatments, including stem cell transplantation, can be pursued. Clinical trial enrolment should be considered at all steps in the process. Molecular phenotyping at diagnosis is valuable. LR indicates lower risk; ESA, erythropoietin stimulating agent; ATG, anti-thymocyte globulin; HR, higher risk; HMA, hypomethylating agent; and HLA, human leukocyte antigen.