What is your approach to treatment of relapsed, high-risk MDS with TP53 mutation in a patient that is not considered a transplant candidate?  

I don't think that there is a particular answer for those with TP53 mutation with the exception of poor prognosis with whatever will be offered to them. I suggest azacitidine-based therapy based on improved overall survival (OS) compared with other approaches. Azacitidine is the treatment of choice ...