MPL and myelodysplastic syndrome: In these patients with LR-MDS, refractory cytopenia, and hypoplastic bone marrow (<25% cellularity), we consider immune-suppressive treatment with anti-thymocyte globulin (ATG), cyclosporine with or without thrombopoietin-receptor agonist (TPO-RA), analogous to the treatment of aplastic anemia [15, 68].