The myelodysplastic syndromes (MDSs) are a heterogeneous group of hematopoietic stem cell malignancies that are characterized by abnormal morphology and impaired bone marrow maturation resulting in progressive cytopenia(s) and a propensity to evolve into acute myeloid leukemia (AML) . The biologic hallmark of the hematopoietic stem cells in MDS is a defective capacity for self-renewal and differentiation. Predisposition to MDS is amplified in the elderly because of senescence-associated depletion of stem cells and associated changes in the marrow microenvironment that may foster ineffective hematopoiesis and may also favor the development of secondary clones . © 2011 Springer Science+Business Media, LLC.
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