Stages of Myelodysplastic Syndromes

by National Cancer Institute

(Page 2 of 2)

There is no staging system for myelodysplastic syndromes. Treatment is based on whether the disease developed after the patient was exposed to factors that cause myelodysplastic syndrome or whether the disease was previously treated. Myelodysplastic syndromes are grouped for treatment as follows:

De novo myelodysplastic syndromes

De novo myelodysplastic syndromes develop without any known cause.

Secondary myelodysplastic syndromes

Secondary myelodysplastic syndromes develop after the patient was treated with chemotherapy or radiation therapy for other diseases or after being exposed to radiation or certain chemicals that are linked to the development of myelodysplastic syndromes. Secondary myelodysplastic syndromes may be harder to treat than de novo myelodysplastic syndromes.

Previously treated myelodysplastic syndromes

The myelodysplastic syndrome has been treated but has not gotten better.

Treatment Option Overview

There are different types of treatment for patients with myelodysplastic syndromes.

Different types of treatments are available for patients with myelodysplastic syndromes. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with a myelodysplastic syndrome. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate treatment is a decision that ideally involves the patient, family, and health care team.

The usual goal of treatment for myelodysplastic syndromes is to prevent symptoms and related problems.

At this time, there is no treatment that will cure myelodysplastic syndrome or stop it from becoming acute leukemia. The usual treatment is supportive care, which helps many patients manage the disease. The main goal of treatment is to prevent symptoms and problems caused by low blood cell counts, such as fatigue and infections. If the disease is severe or gets worse quickly, a more aggressive treatment may be given, such as chemotherapy to kill the blast cells. Side effects of chemotherapy may cause serious health problems and many patients do better with standard supportive care.

Three types of standard treatment are used:

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Supportive care

Supportive care is given to lessen the problems caused by the disease or its treatment. Supportive care may include the following:

Transfusion therapy

Transfusion therapy (blood transfusion) is a method of giving red blood cells, white blood cells, or platelets to replace blood cells destroyed by disease or treatment. Patients who receive frequent red blood cell transfusions may have their tissues and organs damaged from the build up of extra iron. Iron chelation therapy is a treatment that uses drugs that attach to the extra iron. The drug and the iron are removed from the body in the urine.

Platelet transfusions are usually given when the patient is bleeding or is having a procedure that may cause bleeding.

Drug therapy

Erythropoietin may be given to increase the number of red blood cells and lessen the effects of anemia. Sometimes granulocyte colony-stimulating factor (G-CSF) is given with erythropoietin to help the treatment work better.

Anticancer drugs may also be used. Antibiotics may be given to fight infections.

Chemotherapy with stem cell transplant

Stem cell transplant is a method of giving chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of a donor and are frozen for storage. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

Treatment Options for Myelodysplastic Syndromes

De Novo Myelodysplastic Syndromes

Treatment of de novo myelodysplastic syndromes may include the following:

• Supportive care.
• Chemotherapy.
• Stem cell transplant using stem cells from a donor.
• A clinical trial of a new anticancer drug.
• A clinical trial of low-dose chemotherapy with stem cell transplant using stem cells from a donor.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Secondary Myelodysplastic Syndromes

Treatment of secondary myelodysplastic syndromes may include the following:

• Supportive care.
• Chemotherapy.
• Stem cell transplant using stem cells from a donor.
• A clinical trial of a new anticancer drug.
• A clinical trial of low-dose chemotherapy with stem cell transplant using stem cells from a donor.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Previously Treated Myelodysplastic Syndromes

Treatment of previously treated myelodysplastic syndromes may include the following:

• Supportive care.
• A clinical trial of a new treatment, such as stem cell transplant.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

About the Author

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