骨髓增生异常综合征(MDS)是起源于造血干细胞的恶性克隆性疾病，以病态造血，向急性髓细胞白血病(AML)转化风险高为主要表现。异基因造血干细胞移植(allo-HSCT)是目前唯一可治愈MDS的手段，但其疗效受到患者及治疗相关因素的影响。目前，学者围绕基因突变对MDS患者的预后价值、移植前是否桥接去甲基化药物(HMA)展开了深入研究。笔者拟通过对allo-HSCT治疗MDS的适应证与移植时机、影响MDS患者allo-HSCT疗效的因素、allo-HSCT后复发的预测和治疗等方面的研究新进展进行阐述，旨在为改善MDS患者allo-HSCT疗效提供新思路。“,”Myelodysplastic syndrome (MDS) is a group of clonal malignant disorders arise from hematopoietic stem cells. It is mainly manifested by pathological hematopoiesis and high-risk of transforming into acute myeloid leukemia (AML). Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curable strategy for MDS.The efficacy of allo-HSCT was affected by patient-related factors and treatment-related factors. Recently, investigators have made remarkable progress on the prognosis value of genetic mutations in MDS patients and whether pre-transplant hypomethylating agent (HMA) is necessary. This article focuses on recent advances on the indication and optimal time of allo-HSCT, risk factors affecting allo-HSCT efficacy, prediction and treatment of recurrence after allo-HSCT, in order to provide new ideas for improving the effectiveness of allo-HSCT in treatment of MDS patients.