Nakamura R, Saber W, Martens MJ, et al. - Via this multicenter biologic assignment trial, researchers sought to compare reduced-intensity hematopoietic cell transplantation (HCT) vs hypomethylating therapy or best supportive care in individuals 50-75 years of age with intermediate-2 or high-risk de novo myelodysplastic syndromes (MDS). The overall survival likelihood at 3 years was set as the primary outcome. Overall 384 persons were enrolled at 34 centers, who were allocated to the Donor or No-Donor arms based on the availability of a matched donor within 90 days of study registration. As revealed by findings, older persons with higher-risk MDS who had a matched donor identified and received reduced-intensity HCT were shown to experience a significant survival benefit, relative to those without a donor. HCT is thus recommended to be incorporated as an essential component of MDS management plans among fit older adults with higher-risk MDS.