Treatment of MDS
Myelodyspastic Syndromes (MDS) Treatment Options
Once the diagnosis of MDS has been made, you and your doctors will decide on the best treatment for you. The treatment that you are offered will depend on the type of MDS you have, your own wishes, your age, your general well-being or fitness and the IPSS-R score.
Broadly speaking, treatment of MDS includes:
- supportive care – this aims to control the symptoms of MDS
- non-intensive treatment – this treatment tries to slow down the progression of MDS and improve your blood counts
- intensive chemotherapy – this involves giving high doses of chemotherapy in hospital
- stem cell transplant - also known as bone marrow transplant
New treatments are being developed for MDS. The process by which a new treatment is tested and evaluated is called clinical trial. Clinical trials aim to gather the evidence necessary to make a decision about changing standard practice. There are many drugs currently being tested. Your doctors will inform you if you qualify to take part in these trials.
Despite the great progress made in fighting MDS, unfortunately most patients’ MDS cannot be cured - however, MDS can usually be controlled and often improved.
We recommend you to consult an MDS expert , at any time or stage, but especially if you are seeking an additional opinion. These physicians have extensive experience treating MDS patients - and will work with your local haematologist to offer you the best possible care and advice.
Supportive Care
Supportive care is not directed at the underlying disease but rather at controlling the symptoms and complications caused by the disease.
Supportive care includes:
- Blood transfusions, to treat anemia
- Growth factors that stimulate blood production, such as erythropoietin (also known as ‘EPO’)
- Platelet transfusions
- Antibiotics, to treat an infection quickly, as MDS patients have a higher risk of developing infections
More information about Supportive care
- Blood, or red cell transfusions An article about the complexities of assessing and managing blood transfusions for patients with Myelodysplastic Syndromes.
- Understanding Myelodysplasia and Introduction to Blood Transfusion By Dr Dora Foukaneli - Addenbrooke’s Hospital and NHSBT - Cambridge.
- EPO (Erythropoietin) & other Erythropoiesis Stimulating Agents (ESAs) in the Treatment of MDS Dr Chris Dalley, Consultant Haematologist University Hospital Southampton
- What are ESAs? Information and advice on EPO and GCSF Fact sheet for Myelodysplastic Syndrome (MDS) Patients
- Understanding Erythropoiesis The animation below from the MDS Foundation, gives a clear explanation of Erythropoiesis.
New MDS Guide (2024)
A downloadable comprehensive MDS Guide for patients, families and care-givers describes the various types of MDS, diagnosis, treatment and more. Co-written by the MDS UK Patient Support Group and Leukaemia Care, this guide is a brand new edition (April 2024).
If you'd prefer a hard copy, email us at admin1@mdspatientsupport.org.uk and we'll be happy to post one out to you.
Non-intensive Care - Active Treatment
This includes a number of drugs, such as azacitidine (Vidaza), which aim to slow the progression of the disease. They are active treatments, but they are known as "low intensity" or "non-intensive" treatments as they do not have the side-effects normally associated with chemotherapy.
Non-intensive care includes:
- Hypomethylating agents (HMA), which work on the behaviour of cancer cells at the DNA level, e.g. drugs such as azacitidine
- Lenalidomide, only suitable for 5q minus syndrome patients, suppresses the MDS cells, by altering the immune system
- Immunosuppressive therapy, only suitable for those patients whose number of bone marrow cells is unusually low (hypoplastic). Anti-thymocyte globulin (ATG) or ciclosporin are immuno-suppressants.
Primrose Oil to treat Vidaza Skin Rash
Are you receiving the treatment azacitidine/Vidaza? If you experience a rash at the injection site, evening primrose oil can help. Read the following information and always check with your nurse or physician first: Evening Primrose Oil
Intensive Chemotherapy
This treatment is the same as that used to treat acute myeloid leukaemia and aims to kill a significant proportion of the abnormal cells in the bone marrow to allow the bone marrow to work normally again (remission).
Achieving remission, even if not a cure for the disease, can improve your quality of life (often almost to normal quality) as long as the remission lasts.
The treatment, however, has a high number of side effects so patients need to stay in hospital for four to six weeks for each course.
A small proportion of people may be cured by intensive chemotherapy alone, although usually when a donor is available, a stem cell transplant will follow.
Stem Cell Transplant
A stem cell transplant, also known as a bone marrow transplant, offers the chance of curing the disease. About one third of patients who receive this treatment are free of disease over many years but the disease may return (relapse).
Bone marrow transplant, or stem cell transplant, is a treatment that replaces your deceased stem cells with healthy ones.
It's called allogeneic stem cell transplant. Allogeneic means that the transplanted cells are coming from a donor. Healthy bone marrow or stem cells are taken from another person whose tissue DNA is identical or almost identical to yours, so the donor is compatible with you.
The treatment has many side effects and it is important that the decision to have an allogeneic stem cell transplant is carefully thought through by your healthcare team and yourself.
Blood stem cell and bone marrow transplants: the seven steps booklet and download
A booklet from Blood Cancer UK for people who are going to have a stem cell transplant. All their information is free of charge to people affected by blood cancer.
The Seven Steps - The Next Steps
For a small group of patients, the long-term and late effects of the transplant can have a very serious impact on their general health and wellbeing. As a result good quality of life can be difficult to achieve. This book, The Next Steps hopes to address some of these in more detail to help you understand more about the transplant journey.
