Can MDS be Treated?

How is MDS Treated?
Treatment for MDS depends on two main factors: the degree to which blood cell counts are reduced, and the risk of progression to AML.

Induction Chemotherapy
In the high-risk group and the intermediate-risk group II, there is a high rate of progression to AML. These patients should consider receiving intravenous chemotherapy. Relatively strong doses of chemotherapy are given to "induce" control of the disease. One temporary side effect of inductive chemotherapy is further failure of the bone marrow. Initially, chemotherapy kills the bone marrow cells that normally produce platelet and red and white blood cells. This phase lasts several weeks, during which the patient remains hospitalized, receiving red cell and platelet transfusions along with antibiotics to fight infection. Because chemotherapy kills dividing cells elsewhere in the body, not just in the bone marrow, patients experience hair loss, mouth sores, and often diarrhea.

If induction chemotherapy manages to control the myelodysplastic cells, then relatively normal cells should grow. Within several weeks there will be enough red cells and platelet produced in the marrow to require fewer transfusions. Meanwhile, the white cell count should also rise, lessening the risk of infection.

Unfortunately, the chance of controlling MDS with induction chemotherapy is only about 30%. Even in successful cases, the disease often returns within twelve months. Thus aggressive chemotherapy is given to a minority of MDS patients.

Red Cell Transfusion

Alternatives to Red Cell Transfusion
The ideal treatment for anemia is to prevent or improve it so that blood transfusions are unnecessary. The following treatments offer limited success.

Erythropoietin (EPO

Pyridoxine

Deferral

Growth Factors

Platelet Transfusions

Vitamin Therapy

Bone Marrow Transplantation