Conflict-of-interest disclosure G.F.S. has received honoraria from and/or played an advisory role for AbbVie, Amgen, Boehringer-Ingelheim, Celgene, Helsinn Healthcare, Hoffmann-La Roche, Janssen-Cilag, Novartis, and Onconova. He works at Hospital Universitario y Politécnico La Fe, which receives research funding from and/or participates in multiple clinical trials funded by different pharmaceutical companies, including AbbVie, Amgen, Boehringer-Ingelheim, Bristol-Myers Squibb, Celgene, Helsinn Healthcare, Hoffmann-La Roche, Janssen-Cilag, Novartis, and Onconova. He is also a member of the Spanish Group on Myelodysplastic Syndromes (Grupo Español de Síndromes Mielodisplásicos), which is sponsored by Celgene and Novartis. Off-label drug use: Azacitidine is approved in Europe only for higher-risk MDS (IPSS intermediate-2 and high risk categories). Preliminary results for several nonapproved drugs under investigation in clinical trials for patients with MDS are presented and discussed.