While standard protocols have been established for the treatment of virtually all cancers, physicians will often modify them for their individual patients. These modifications are based on many factors including the patient’s age, general health, desired results, and the specific characteristics of his or her cancer. Since the treatments described in this report represent the standard therapeutic approaches, your physician may not strictly adhere to them.

There is only one generally recognized curative treatment for MDS—allogenic stem cell transplant (SCT), or bone marrow transplant (BMT) . Most doctors recommend SCT for otherwise healthy patients under the age of 50. The American Cancer Society states “about one-third of MDS patients receiving allogenic SCT may be cured, but between one-fourth to one-third may die from complications of this treatment.”

Conventional chemotherapy is used to treat advanced MDS. There are three standard combinations of chemotherapy drugs used. These combinations include cytarabine and idarubicin, cytarabine and topotecan, and cytarabine and fludarabine. This treatment can have serious side effects and may not be an option for all patients, especially those who are elderly.

Certain medications have also helped treat the disease. A newer type of drug called a hypomethylating agent has shown positive results in treating MDS. Two drugs are available, azacitidine (Vidaza) and decitabine (Dacogen). These drugs work by slowing down cell growth. Some patients have shown improved blood counts, reduced risk of leukemia, and a longer life with these drugs. Immunomodulating drugs are also used to treat MDS. These drugs alter the immune system and include thalidomide and lenalidomide (Revlimid). Lenalidomide is a newer drug and is generally preferred over thalidomide because of fewer side effects. Immunosuppressant drugs are used to treat certain types of MDS. Anti-thymocyte globulin (ATG) and cyclosporine are both immunosuppressants used in the treatment of MDS.

All other interventions are supportive and depend on which family of blood cells is involved. The mainstays of treatment have been blood component transfusions to replace the deficient cell types and antibiotics to treat the infections. Radiation therapy is not used for the treatment of MDS.

Clinical Trials

Treatment protocols have been established and continue to be modified through clinical trials. The research studies are essential to determine whether or not new treatments are both safe and effective. Since highly effective treatments for many cancers remain unknown, numerous clinical trials are always underway around the world. You may wish to ask your doctor if you should consider participating in a clinical trial. You can find out about clinical trials at the government website ClinicalTrials.gov .