Understanding the evolving role of early palliative care in myelodysplastic syndromes: a 2026 narrative review.

Myelodysplastic Syndromes/Neoplasms (MDS) are a heterogeneous group of blood cancers characterized by a broad spectrum of symptoms and varying impacts on quality of life (QoL). Although the integration of early PC care has long been recognized as an essential part of comprehensive management for patients with solid tumors, experience in the context of MDS is still limited. However, symptom control, QoL, advanced care planning goals, the reduction of aggressive therapies, intensive care use, including intubation before death, and resource use in the end-of-life (EOL) phase are critical issues that are enhanced through early PC in MDS management. Additionally, integrating standard hematological measures with early PC leads to fewer visits and hospital admissions near the EOL, particularly during the last 30 days. Moreover, patients with early PC die at home or in hospice care at a rate nearly in line with their preferences. Therefore, routine early PC is a critical issue for patients with MDS, regardless of disease risk, as it improves patient outcomes, enhances communication, refines resource use, and reduces unnecessary aggressive procedures.