Treatment for myelodysplastic syndrome (MDS)

Main treatments for myelodysplastic syndrome (MDS)

Myelodysplastic syndrome (MDS) often develops very slowly. You may not need treatment straight away.

Treatment will depend on:

• your symptoms
• the type of MDS you have
• how quickly your symptoms are expected to get worse, and the risk of MDS developing into acute myeloid leukaemia (the risk group)
• your age
• your general health

If you have low risk MDS and few symptoms you'll usually just have regular check-ups, including blood tests. You may need treatment in the future if your condition gets worse.

If you have higher risk MDS, treatment may include chemotherapy or a stem cell transplant. You may also have medicines called immunosuppressants, targeted medicines or immunotherapy.

You'll also have treatments to prevent and manage symptoms (called supportive treatments).

The specialist care team looking after you will:

• explain the treatments, benefits and side effects
• work with you to create a treatment plan
• help manage any side effects

You'll have regular check-ups and tests during and after any treatments.

If you have any symptoms or side effects that you're worried about, talk to your specialists. You do not need to wait for your next check-up.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

It's one of the main treatments for higher risk MDS.

You might have chemotherapy before having a stem cell transplant (called intensive chemotherapy).

Or you might have a type of chemotherapy that causes fewer side effects, if stronger chemotherapy or a stem cell transplant are not suitable for you (called non-intensive chemotherapy).

Stem cell transplant

A stem cell transplant replaces the damaged stem cells in your bone marrow with healthy ones from a donor.

It can sometimes cure MDS, but it's not suitable for everyone. It may be recommended if:

• you have lower risk MDS and other treatments have not worked
• you have higher risk MDS and you're in good health apart from your MDS

Immunosuppressants

Immunosuppressants are medicines that reduce the activity of your immune system.

They can be used to treat certain types of MDS.

Targeted medicines and immunotherapy

Targeted medicines kill cancer cells.

Immunotherapy is where medicines are used to help your immune system kill cancer.

These medicines are used to treat certain types of MDS. The main treatment is a medicine called lenalidomide, which can help with symptoms and reduce the need for supportive treatments such as blood transfusions.

Supportive treatment

You may also need to have supportive treatment to prevent or control symptoms caused by MDS.

This is usually:

• blood transfusions to increase your number of healthy blood cells
• medicines called growth factors to help your body make more blood cells
• antibiotics if you need treatment for infections

What happens if you've been told your cancer cannot be cured

If you have advanced MDS it might be very hard to treat. It may not be possible to cure the cancer.

If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.

Finding out the cancer is advanced and cannot be cured can be very hard news to take in.

You will be referred to a special team of doctors and nurses called the palliative care team or symptom control team.

They will work with you to help manage your symptoms and make you feel more comfortable.

The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.