Conclusions
In conclusion, HRQoL in MDS is generally poor and strongly influenced by transfusion-dependence. It is suggested that treatment reducing transfusion requirement per se could improve the well-being patterns in MDS. QOL-E  is a multiple domain, concise, reliable, and valid instrument for the assessment of quality of life in MDS patients. The impact of MDS and its treatment has been yet been thoroughly explored, and this validated questionnaire has been developed to assess quality of life in this particular patient population.