7028 Background: A recent phase III trial showed AZA is the first treatment to significantly extend overall survival (OS) in higher- risk MDS pts (Fenaux, Blood 2007;110:817). This subsequent analysis explored improvements in patient outcomes during prolonged survival, as reflected by transfusion requirements, cytopenias, levels of anemia, infections requiring antimicrobial agents, and hospitalization days. Methods: 358 pts with higher-risk MDS, defined as FAB RAEB, RAEB-T, or CMML and IPSS Int-2 or High, were enrolled. Pts were randomized to AZA (75 mg/m2/d SC x 7d q 28d) + best supportive care (BSC) or conventional care regimens (CCR). CCR + BSC included low-dose ara-C (20 mg/m2/d x 14d q 28d), or standard chemotherapy (7+3 regimen), or BSC only. Prophylactic G-CSF and erythropoietin were not allowed. Results: Significantly more RBC transfusion-dependent pts at baseline (BL) achieved transfusion independence (TI) with AZA vs CCR and significantly more pts who were RBC TI at BL remained TI with AZA vs CC...