This is an invited review of a condition that is likely to become incr
easingly frequent in coming years. The objective is to define the vary
ing prognoses of the condition and to discuss treatment options for pa
tients with better and worse prognoses. The source of the data is the
literature. Of particular note are the paper by Greenberg et al. descr
ibing the International Prognostic Scoring System for MDS and that by
Estey et al. describing the similar response of AML, RAEB-t, and RAEB
to AML-type chemotherapy. The state of the art is that no satisfactory
therapeutic options exist; consequently, the majority of patients wit
h secondary MDS should participate in clinical trials.