Myelodysplastic syndromes (MDS) are characterized by hypercellular bone marrow, peripheral cytopenia and an increased rate of intramedullary apoptosis. Oxidative stress is known as an important factor that leads to apoptosis in MDS. Thus, amifostine was investigated in a randomized, multicentre phase II-study (n = 44 pts.; 22 amifostine, 22 best supportive care). We found an overall haematologic response rate of 18%. One patient developed a complete and persisting haematologic remission. Haematologic progression rate was 46% in the treatment group and 64% in the control group. We conclude that amifostine has the potential to induce haematologic response in individual patients suffering from MDS.