Evidence is accumulating to indicate that alterations in the control o
f apoptosis can contribute to a variety of disorders. Among the disord
ers associated with abnormal regulation of apoptosis, MDS stands out u
nequaled in that apoptosis is related, in apparently opposite directio
ns, to ineffective hematopoiesis and leukemic transformation of MDS; n
otably, excessive apoptosis in the former and deranged apoptosis or es
cape from apoptotic control in the latter. In this review, we want to
focus on the role of apoptosis in various stages of MDS, and to discus
s its possible relevance to further therapeutic interventions.