A Multi-Center Phase III Trial Comparing Reduced Intensity Allogeneic Hematopoietic Cell Transplant to Hypomethylating Therapy or Best Supportive Care in Patients aged 50-75 with Intermediate-2 and High Risk Myelodysplastic Syndrome

Study Design: This study is designed as a multicenter trial, with biological assignment to one of two study arms; Arm 1: Reduced intensity conditioning allogeneic hematopoietic cell transplantation (RIC-alloHCT), Arm 2: Non-Transplant Therapy/Best Supportive Care. Primary Objective: The primary objective is to compare the three-year overall survival (OS) probabilities between two treatment arms. Secondary Objectives: Patients will also be assessed for the following: 1. Compare leukemia-free survival (LFS) at 3 years from enrollment 2. Compare Quality of Life (QOL) measures between treatment arms