We acknowledge the Traditional Owners of Country throughout Australia and their continuing connection to the land, sea and community. We pay our respects to them and their cultures and to Elders past, present and emerging.

This work is available from the Leukaemia Foundation website and from the Cancer Council website.

This edition published in October 2021. ISBN: 978-0-6453299-1-9

Leukaemia Foundation and Australian Government Department of Health 2021, Optimal care pathway for people with myelodysplastic syndromes, 1st edn, Leukaemia Foundation of Australia.

Enquiries about this publication can be sent to bloodcancerpartnerships@leukaemia.org.au.

Associate Professor Anoop Enjeti (Chair), Haematologist, NSW Health Pathology John Hunter Hospital, Senior Staff Haematologist, Calvary Mater Hospital, Conjoint Associate Professor University of Newcastle

Dr Sharon Avery, Haematologist, Cairns and Hinterland Hospital and Health Service

Jenni Bourke, Occupational Therapist, Blood Cancer Support Coordinator, Leukaemia Foundation

Professor David Curtis, Haematologist and Bone Marrow Transplant Physician, Alfred Health and Australian Centre For Blood Diseases, Monash University

Rebecca Dring, Clinical Nurse Consultant, Royal Melbourne Hospital and Peter MacCallum Cancer Centre

Dr Carolyn Ee, General Practitioner, Western Sydney University, Primary Care Collaborative Cancer Clinical Trials Group

Dr Sally Greenaway, Haematologist, Westmead Hospital

Dr Yasmin Harvey, Haematologist, Sullivan Nicolaides Pathology

Christine Heath, Consumer Representative

Dr Devendra Hiwase, Haematologist,

Royal Adelaide Hospital, Associate Professor University of Adelaide

Associate Professor Melita Kenealy, Haematologist, Cabrini Hospital and Adjunct Associate Professor (Clinical), Monash University

Julie Tovey, Blood Cancer Support Coordinator, Registered Nurse, Leukaemia Foundation

Dr Nienke Zomerdijk, Research Fellow Psycho- Oncology, University of Melbourne and Victorian Comprehensive Cancer Centre Alliance

Dr Duncan Purtill, Haematologist and Bone Marrow Transplant Physician Consultant, Fiona Stanley Hospital and Pathwest Laboratory Medicine

Dr Robin Gasiorowski, Haematologist, Concord Hospital, Macquarie University Hospital, University of Sydney, Macquarie University

Professor Paula Marlton, Haematologist, Princess Alexandra Hospital

Professor John Pimanda, Haematologist, Prince of Wales Hospital and Lowy Cancer Research Centre, UNSW Sydney

Professor David Ritchie, Haematologist, Bone Marrow Transplant Specialist, Peter MacCallum Cancer Centre and Royal Melbourne Hospital

Associate Professor William Stevenson, Haematologist, Royal North Shore Hospital

Australian Capital Territory Health Allied Health Professions Australia

Australian and New Zealand Children’s Haematology/Oncology Group

Australia and New Zealand Transplant and Cellular Therapies

Australasian Association of Nuclear Medicine Specialists

Australasian College of Emergency Medicine Australasian Leukaemia & Lymphoma Group

Australian and New Zealand Society of Palliative Care

Australian College of Nursing

Australian College of Rural and Remote Medicine Australian Government Department of Health and Ageing

Australian Medical Association Beyond Blue

Cancer Australia

Cancer Council of Australia Cancer Council Victoria Cancer Institute NSW

Cancer Nurses Society of Australia Canteen

Clinical Oncology Society of Australia Haematology Society of Australia & New Zealand Launceston General Hospital

Leukaemia Foundation Lymphoma Australia

Medical Oncology Group of Australia Myeloma Australia

Northern Territory Department of Health Palliative Care Australia

Private Cancer Physicians of Australia Queensland Health

Rare Cancers Australia Redkite

Royal Australasian College of Physicians

Royal Australian and New Zealand College of Radiologists

Royal College of Pathologists of Australasia South Australia Health

Tasmanian Department of Health and Human Services

The Royal Australian College of General Practitioners

Victorian Department of Health

Western Australia Cancer and Palliative Care Network

Associate Professor Peter Mollee (Chair), Haematologist Princess Alexandra Hospital, Australasian Leukaemia and Lymphoma Group, Associate Professor, University of Queensland

Dr Caroline M Bateman, Paediatric Haematologist and Oncologist, Cancer Centre for Children, The Children’s Hospital at Westmead

Julia Brancato, Optimal Care Pathways Project Coordinator, Cancer Council Victoria

Dr Peter Diamond, Project Secretariat, Leukaemia Foundation

Associate Professor Michael Dickinson, Haematologist, Lymphoma Australia, Peter MacCallum Cancer Centre, Royal

Melbourne Hospital, University of Melbourne

Associate Professor Anoop Enjeti, Haematologist, NSW Health Pathology – John Hunter Hospital, Senior Staff Haematologist, Calvary Mater Hospital, Conjoint Associate Professor University of Newcastle

Emily Forrest, Project Secretariat, Leukaemia Foundation

Fiona Haigh, Project Secretariat, Leukaemia Foundation

Deborah Henderson, Consumer Representative

Professor Tim Hughes, Haematologist,

South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide, Royal Adelaide Hospital

Professor Steven Lane, Clinical Haematologist, Royal Brisbane and Women’s Hospital, QIMR Berghofer Medical Research Institute, University of Queensland

Caroline Nehill, Director National Cancer Control, Cancer Australia

Professor H. Miles Prince AM, Clinical Haematologist, Epworth Healthcare and Haematologist Peter MacCallum Cancer Centre

Professor Hang Quach, Haematologist, University of Melbourne, St. Vincent’s Hospital Melbourne

Catriona Rafael, Project Secretariat, Leukaemia Foundation

Professor Andrew Roberts AM, Haematologist and Bone Marrow Transplant Physician,

The Royal Melbourne Hospital, Peter MacCallum Cancer Centre, University of Melbourne, Walter and Eliza Hall Institute

Professor John Seymour AM, Clinical Haematologist, Peter MacCallum Cancer Centre, Royal Melbourne Hospital, University of Melbourne

Delaine Smith, Chief Executive Officer, Australasian Leukaemia and Lymphoma Group

Professor Judith Trotman, Haematologist, Concord Repatriation General Hospital, University of Sydney

Megan Varlow, Director Cancer Control Policy, Cancer Council Australia

Dr Nicole Wong Doo, Clinical and Laboratory Haematologist, Concord Repatriation and General Hospital, University of Sydney

Our thanks also to the Blood Cancer Taskforce, which recommended the development of optimal care pathways for all the major blood cancer subtypes as part of the National Strategic Action Plan for Blood Cancer (2020). The National Action Plan was commissioned by the Federal Government and developed by the Blood Cancer Taskforce, with support from the Leukaemia Foundation.

Not all patients with MDS require ongoing input from a multidisciplinary team. Where required, the multidisciplinary team may include the following members:

• care coordinator (as determined by multidisciplinary team members)*
• haematologist*
• infectious diseases physician*
• nurse (with appropriate expertise or under the supervision of nurses with appropriate expertise)*
• pathologist including pathologist with molecular genetic expertise*
• pharmacist*
• Aboriginal health practitioner, Indigenous liaison officer or remote general practitioner
• fertility specialist
• spiritual/pastoral care
• clinical trials coordinator
• dentist
• dietitian
• exercise physiologist
• general practitioner
• genetic counsellor
• geriatrician
• nuclear medicine physician
• occupational therapist
• palliative care specialist
• physiotherapist
• psychiatrist
• psychologist
• radiation oncologist
• radiologist/imaging specialists
• social worker
• spiritual/pastoral

* Denotes core members. Core members of the multidisciplinary team are expected to attend most multidisciplinary team meetings either in person or remotely.