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Nancyann,
For a 91-year-old, supportive care (transfusions) is the most usual approach. If he's tired of being tired, getting blood is the most straightforward way to help.
You have the right question for the new doctor: are there other choices since he's in pretty good shape overall? If so, what are the tradeoffs? I'd also ask whether his MGUS is a factor.
Even if a drug treatment is available, you'll have to consider whether your father would want to try it. If he hates going to the hospital for something as simple as a transfusion, he may not want everything that comes with drug treatments: more trips to the hospital, more tests, and the possible side effects. Since he's doing as well as he is, quality of life can't be ignored.
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