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]

Medical therapy

Treatment is based on the type of MDS and the person's age and general health. The goal of treatment for MDS is to:

• Relieve symptoms
• Slow or prevent progression of the disease
• Improve quality of life

Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It may also be used to treat people whose MDS progresses to acute myelogenous leukemia. The most common chemotherapy drug used to treat MDS is cytarabine (Cytosar, Ara-C). Cytarabine may be combined with:

• Idarubicin (Idamycin)

• Topotecan (Hycamtin)

• Fludarabine (Fludara)

Other chemotherapy drugs that may be used to treat MDS include: Daunorubucin (Cerubidine) Mitoxantrone (Novantrone)

Supportive therapy

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

Transfusions

People with low red blood cell counts (anemia) may be given blood transfusions.

Frequent blood transfusions can result in a buildup of extra iron, which is treated with drug therapy.

People with bleeding problems due to low platelet counts may be given platelet transfusions.

Growth factors

Shortages of blood cells cause most of the symptoms of MDS. Growth factors help return blood cell counts to normal.

• Epoetin (Eprex, erythropoietin)

• Helps improve production of red blood cells

• Filgrastim (Neupogen)

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

• Pegfilgrastim (Neulasta)

• A long-acting G-CSF

Drug therapy

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

• Deferoxamine (Desferal or DFO)

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

• Lenalidomide (Revlimid)

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

• Antithymocyte globulin (ATG)

• decreases the need for transfusions in certain types of MDS

• Antibiotics

• help to prevent or treat infections

• Hypomethylating agents, such as 5-azacytidine or decitabine (Dacogen)

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

Stem cell transplant

A stem cell transplant may be a treatment option for younger people and those with high-risk MDS.

References

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