Myelodysplastic syndrome (MDS) is a malignant clonal disease of acquired hematopoietic stem cells. According to the symptoms of high-risk MDS in the elderly

it belongs to the category of

suǐ dú láo

(marrow poisoning and fatigue) in traditional Chinese medicine. Its etiology and pathogenesis are based on deficiency of the spleen and kidney

coupled with blood stasis and other pathogenic factors. Clinical principle of syndrome differentiation and treatment: detoxification and removing blood stasis as the core

tonifying spleen and kidney as the foundation; the approach of regulating and tonifying the spleen and stomach

and soothing liver and regulating qi is also emphasized. The combined use of cold and heat medicinals is key in the treatment

and special attention is given to maintaining the yin and yang balance. This paper summarizes the experience of diagnosis and treatment of elderly high-risk MDS based on clinical case records.