 - Physicians Choice of alternative treatment, which may include any approved or standard-of-care therapy that the patient has not shown to be hypersensitive to, based on frequently used treatment for MDS, as per institutional guidelines, after receipt of HMAs N approximately 75 patients. The drugs used in the Physicians Choice arm should be used according to the recommendations, if clinically appropriate, provided in the corresponding Summary of Product Characteristics SmPC and Prescribing Information of these drugs. Experimental therapies are not allowed on the PC arm. 