Module 3. Management and Treatment of MDS

Managing and Treating MDS
How is MDS treated?
Goals of treatment for low-risk MDS
Goals of treatment for high-risk MDS
What are the different types of treatment for MDS?
Observation for MDS
Supportive care for MDS
Supportive care for MDS – Blood transfusions
Supportive care for MDS – Platelet transfusions
Blood transfusion safety
Iron overload
Supportive care for MDS – Growth factors
Disease-modifying treatment for MDS
Disease-modifying treatment for MDS
Disease-modifying treatment for MDS
Clinical trials
Chemotherapy for MDS
Nutrition and vitamins to help manage symptoms and side effects

*Please note: This slide show represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.

How is MDS treated?

Your MDS treatment depends on the following factors:

  • Your general health, your life situation, and choices,
  • Your MDS type, risk category, and any genetic changes,
  • Whether a blood and marrow transplant is possible, and
  • What treatments are available to you.

Goals of treatment for low-risk MDS

The goals of treatment are different for people with low-risk and high-risk MDS.

If you have low-risk MDS, the goals are to help your blood make more healthy cells, reduce the number of blood transfusions you need, and help you enjoy a good quality of life for as long as possible.

Goals of treatment for high-risk MDS

If you have high-risk MDS, the goals are to keep your MDS from progressing to leukemia for as long as possible, improve your quality of life by treating symptoms, and help you live as long and healthy a life as possible.

What are the different types of treatment for MDS?

The main MDS treatment options are observation, supportive care, and disease-modifying treatment.

You might have some or all of these treatments, depending on your MDS type and risk category.

Observation for MDS

With observation, your doctor checks your blood counts and symptoms regularly. How often you have check-ups depends on your health and any changes that happen.

Supportive care for MDS

Supportive care can include blood transfusions, medicines to help healthy blood cells develop, treatment to manage any side effects, and working with a nutritionist and counselor for help with eating well and coping with the challenges of a long-term disease.

Supportive care for MDS – Blood transfusions

Blood transfusions are red cells or platelets given directly into your bloodstream. About 9 of 10 people with MDS get transfusions at some point. This process takes several hours. You may need a transfusion every few months, every week, or some time in between, depending on your MDS.

Supportive care for MDS – Platelet transfusions

Platelet transfusions are given if you have a high risk of bleeding too much. You receive them by transfusion, as often as your doctor prescribes.

Blood transfusion safety

Blood transfusions are generally very safe. Donor blood and platelets are carefully tested to match your blood type and be free of infectious agents.

Infections are very rare. Some people develop allergic reactions to donor blood or have fevers that last a short time.

Iron overload

Having frequent blood cell transfusions can cause a condition called iron overload. The extra iron may harm your liver and other organs. If you get iron overload, doctors will give you medication to remove the extra iron and protect your liver and other organs.

Supportive care for MDS – Growth factors

Supportive care also includes giving medications called growth factors to help your bone marrow make healthy blood cells. These are given as a shot. Doctors may prescribe erythropoietin (EPO) to help your body develop red blood cells.

Disease-modifying treatment for MDS

Disease-modifying treatments are also available in MDS. These aim to modify the bone marrow changes that cause MDS. If you have high-risk MDS, you might start with disease-modifying treatment instead of observation. You may still have some supportive care, such as nutrition support and counseling.

Disease-modifying treatment for MDS

Drugs called azacitidine and decitabine are available to treat MDS. They work by turning on genes to kill the cancer cells.

Disease-modifying treatment for MDS

Another drug, lenalidomide, is approved for people who have a specific genetic change.

You may need disease-modifying drugs if you need frequent transfusions, if treatments are not helping your symptoms, or if you have a high blast cell count.

Clinical trials

If one disease-modifying drug does not work or stops working, talk to your doctor about trying another drug or a combination of drugs. Or, your doctor may recommend you enroll in a clinical trial. Clinical trials offer treatments that are not yet available to the public but are safe enough for patient volunteers.

Chemotherapy for MDS

A treatment called induction chemotherapy is an option for some MDS patients. This treatment uses chemotherapy to kill the abnormal cells in your bone marrow.
It is given in the hospital, can make you sick, and does not always control MDS, so only a few people have this treatment.

Your doctor will discuss it with you and tell you if it might be an option.

Nutrition and vitamins to help manage symptoms and side effects

Whatever treatment you need, good nutrition and vitamins can help you manage symptoms and side effects. A nutritionist specializing in cancer and MDS can help you feel better and have more energy.

Work closely with your doctor

MDS is a challenging disease that varies greatly from person to person. Working closely with your doctor and understanding as much as possible about the disease and treatment options can help you live as long and well as possible.

Slide Show - Management and Treatment of MDS

This slide show explains the current treatment approaches for myelodysplastic syndromes (MDS). Treatment options are grouped into 3 main types: observation, supportive care, and disease-modifying treatment. The slide show also describes the goals of treatment for low-risk versus high-risk MDS, as well as clinical trials.
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Animation - Management and Treatment of MDS
1. Animation - Management and Treatment of MDS
Slide Show - Management and Treatment of MDS
2. Slide Show - Management and Treatment of MDS

Expert Videos

What are the treatment options for MDS?
3. What are the treatment options for MDS?
How is lower-risk MDS treated?
4. How is lower-risk MDS treated?
How is higher-risk MDS treated?
5. How is higher-risk MDS treated?
What is supportive care for MDS?
6. What is supportive care for MDS?
Are vitamin supplements beneficial for MDS treatment?
7. Are vitamin supplements beneficial for MDS treatment?
What are erythropoietin-stimulating agents (ESAs)?
8. What are erythropoietin-stimulating agents (ESAs)?
What is cytotoxic chemotherapy and when is it used for MDS?
9. What is cytotoxic chemotherapy and when is it used for MDS?
What is lenalidomide and when is it used for MDS?
10. What is lenalidomide and when is it used for MDS?
What are hypomethylating agents and when are they used for MDS?
11. What are hypomethylating agents and when are they used for MDS?
How long will MDS treatment be given?
12. How long will MDS treatment be given?
What is immunosuppressive therapy and when is it used for MDS?
13. What is immunosuppressive therapy and when is it used for MDS?
What other options are there if first-line MDS treatment doesn’t work?
14. What other options are there if first-line MDS treatment doesn’t work?

Patient Videos

David's story: How was your MDS initially treated?
15. David's story: How was your MDS initially treated?

This educational activity has been developed by
the Myelodysplastic Syndromes Foundation, Inc and Mechanisms in Medicine Inc.

This activity is supported by charitable grants from Celgene Corporation, Jazz Pharmaceuticals, Novartis, and Takeda Oncology.

This website is part of the Animated Patient™ series developed by Mechanisms in Medicine Inc., to provide highly visual formats of learning for patients to improve their understanding, make informed decisions, and partner with their health care professionals for optimal outcomes.