Patients with MDS for whom hypomethylating agents have failed have poor outcomes overall. This figure shows Kaplan-Meier survival analysis according to subsequent post-hypomethylating agent salvage regimen. A small subset of patients who are younger or have a better performance score and are eligible for a clinical trials or stem cell transplantation have a survival exceeding 1 year, but most patients receive only supportive/palliative care and live <6 months. Recent data suggest that patients who still have lower-risk disease but have not responded to azacitidine or decitabine have a have a median survival of ∼15 months.128 AZA, azacitidine; ORR, overall response rate; OS, overall survival. Original figure copyright American Society of Clinical Oncology121 ; used with permission.