Family member newly diagnosed with MDS

Hi everyone,

I have a brother newly diagnosed with MDS. He has had low platelets in the 70,000 range for 7+ years and has been on a wait-and-see, but they just diagnosed it officially last week. We are heading to the Mayo Clinic next month for further discussions. Thank God, he doesn't have any symptoms yet.

Do most people in this situation go straight to the stem cell transplant? Is there an interim step? He's 56 and we want him to live a very long and healthy life. Thanks for any advice!