Treatments for Myelodysplastic Syndrome (MDS)
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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.
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 .
American Cancer Society website. Available at: http://www.cancer.org/ .
Castro-Malaspina H, O’Reilly RJ. Aplastic anemia and the myelodysplastic syndromes. In Harrison's Principles of Internal Medicine . 14th ed. McGraw-Hill; 1998.
Children’s Hospital Boston website. Available at: http://www.childrenshospital.org .
Detailed guide: myelodysplastic syndrome. American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=65. Accessed April 2, 2009.
Lewis R. Silverman MD. Myelodysplastic syndrome. In: Cancer Medicine . American Cancer Society website. Available at: http://www.nci.nih.gov/cancer_information/ . Accessed November 2002.
Last reviewed April 2009 by ]]>Igor Puzanov, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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