Submit Comments by 09/01/2025

Although you can comment on any guidance at any time (see 21 CFR 10.115(g)(5)), to ensure that the FDA considers your comment on a draft guidance before it begins work on the final version of the guidance, submit either online or written comments on the draft guidance before the close date.

If unable to submit comments online, please mail written comments to:

Dockets Management
Food and Drug Administration
5630 Fishers Lane, Rm 1061
Rockville, MD 20852

All written comments should be identified with this document’s docket number: FDA-2025-D-0649

Docket Number: FDA-2025-D-0649 Issued by:

Guidance Issuing Office

Oncology Center of Excellence

The purpose of this guidance is to assist sponsors in the clinical development of drug and biological products for the treatment of the myelodysplastic syndromes (MDS), specifically the development of drugs that are considered disease-modifying, and not drugs that are considered as supportive therapy (e.g., erythropoiesis-stimulating agents). Furthermore, the guidance will not address drug development for MDS/myeloproliferative neoplasm overlap syndromes, such as chronic myelomonocytic leukemia, which are considered a separate class of myeloid neoplasms.