Siteman Cancer Center offers many effective treatments for patients with myelodysplastic neoplasms. The right treatment plan depends on your specific MDS type, risk score, overall health, and other factors that contribute to quality of life.
At Siteman, your doctors will create a treatment plan that best matches your specific situation and needs for the right outcomes for you.
What Treatment Could I Have for MDS?
MDS treatment falls into four main categories. Your care team will determine which of these best fits your diagnosis and goals:
Supportive care
Supportive care usually involves medication and transfusions that focus on easing MDS symptoms. They help stabilize blood cell counts and improve the quality of life by easing side effects of the disease.
Drug therapy
There are several targeted medications used to treat MDS, including chemotherapy, immunotherapy, and other immunosuppressant drugs.
Allogenic stem cell transplants
Transplants are the most aggressive form of treatment for MDS and are currently the only known path to long-term remission for patients who have high-risk scores.
Stem cell transplants, also called hematopoietic stem cell transplants (HSCT), replace a patient’s abnormal stem cells with healthy donor cells so that their bone marrow can produce healthy cells again.
Siteman Cancer Center has more clinical trials available for patients to enroll in than any other cancer center in the region. For patients with MDS, these research studies give them access to promising treatments before they become standards of care.
Frequently Asked Questions About MDS Treatment
Supportive care focuses on managing symptoms rather than treating MDS directly. Because MDS impairs how your bone marrow makes blood cells, you may experience anemia, frequent infections, or easy bleeding. Supportive care addresses these issues so you can maintain your quality of life.
For patients with low-risk MDS, supportive care alone may be all that you need. Depending on your age, overall health, and risk score, it may give you years of stable, comfortable living without more aggressive treatment.
The types of supportive care you may receive include growth factor drugs like epoetin alfa and filgrastim, blood transfusions with transfusion support if needed, and platelet support medications like aminocaproic acid.
Drug therapy for MDS directly treats the abnormal cells. The right medication depends on your MDS subtype, risk score, and how your body has responded to prior treatment.
Drug therapy options include chemotherapy (azacitidine and decitabine), immunotherapy (lenalidomide), and targeted therapy (imetelstat). There are also newer medications like luspatercept for patients who have not had success with blood transfusions.
For patients with higher-risk MDS, a stem cell transplant offers the best chance at long-term remission. The goal is to replace your bone marrow’s abnormal stem cells with healthy ones from a matched donor. Transplants help reset the system so your body can produce healthy blood cells again.
Allogeneic transplants are most common in MDS. Donors may be a close relative or found through national registries like the National Marrow Donor Program (NMDP). Research WashU Medicine experts are leading in haploidentical “half-matched” transplants is expanding access for the option and making it safer. They continue to find ways to lessen the chances of graft vs. host disease (GvHD) for patients receiving haploidentical transplants.
At Siteman Cancer Center, our patients with MDS don’t receive radiation therapy. Because MDS is a disease of the bone marrow that affects blood cells throughout the entire body, localized treatments like surgery or radiation can’t reach it. Treatment must work systemically.
Allogeneic and haploidentical transplants are successful and can cure patients’ cancer on their own. They achieve positive results for patients without the side effects of radiation or surgery.
Leading in Stem Cell Transplants
Siteman Cancer Center has performed over 10,000 stem cell transplants, making us one of the most experienced transplant programs in the United States. That volume translates into better outcomes, more refined protocols, and a care team that has seen and managed every complexity.