Myelodysplastic syndrome medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Overview

Chemotherapy is recommended among all patients who develop myelodysplastic syndrome.

Medical Therapy

• Treatment is based on the type of myelodysplastic syndrome and the person's age and general health. The goal of treatment for myelodysplastic syndrome is to:
  • Relieve symptoms
  • Slow or prevent progression of the disease
  • Improve quality of life

Chemotherapy

• The most common chemotherapy drug used to treat myelodysplastic syndrome is cytarabine. Cytarabine may be combined with other pharmacological agents such as:
  • Idarubicin
  • Topotecan
  • Fludarabine
• Other chemotherapeutic agents that may be used to treat myelodysplastic syndrome include:
  • Daunorubucin
  • Mitoxantrone

Supportive Therapy

• Supportive therapy is given to relieve symptoms and lessen the problems caused by abnormal blood cell counts or treatment for myelodysplastic syndrome.

Transfusions

• Patients with anemia may receive blood transfusions to correct the red blood cell counts.
• Frequent blood transfusions can be complicated by a buildup of extra iron in the body, which is treated with drug therapy.
• Patients with bleeding problems due to low platelet counts may be given platelet transfusions.

Growth Factors

• Epoetin (erythropoietin)

• Helps improve production of red blood cells

• Filgrastim

• Also called granulocyte colony-stimulating factor (G-CSF)
• Helps improve production of white blood cells

• Pegfilgrastim

• A long-acting G-CSF

Supportive Therapy

• Other drugs that may be used to treat symptoms or side effects of therapy include:
• Deferoxamine

• treats excess iron in the blood
• sometimes given with Vitamin C.

• Lenalidomide

• decreases the need for transfusions in people with a specific chromosome change

• Antithymocyte globulin

• decreases the need for transfusions in certain types of myelodysplastic syndrome

• Antibiotics

• help to prevent or treat infections

• Hypomethylating agents, such as 5-azacytidine or decitabine

• stop cancer cells from producing DNA or RNA so the cells die

References

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