As with all cancers, treatment for myelodysplastic syndromes (MDS) is usually coordinated by a cancer care team, headed by a medical oncologist or hematologist. There are a variety of methods used to treat MDS and their symptoms and complications. The exact treatment method chosen for each patient depends on the type of MDS, as well as certain prognostic factors including the patient’s age and overall health.

Common treatment methods for MDS include:

• Bone marrow/stem cell transplant. Transplantation of bone marrow cells or peripheral blood stem cells. Patients who undergo transplantation receive an infusion of healthy stem cells through a vein after either high-dose or low-dose chemotherapy or radiation therapy. The chemotherapy or radiation treatments allow the transplant to take hold, grow and replace the abnormal bone marrow.  When used to treat MDS, the stem cells must come from a matched donor.
  
  This procedure is considered the best, and in most cases the only curative treatment for people with MDS. According to the American Cancer Society (ACS), approximately one-third of MDS patients receiving allogenic bone marrow/stem cell transplantation may be cured. However, approximately one-fourth to one-third of the patients may die from complications of the treatment. The outlook for a cure is best for young patients whose MDS has not begun to progress into acute myeloid leukemia (AML).  This procedure is still fairly new and complex and cannot be used with all patients.
  
  
• Chemotherapy. Uses powerful drugs to destroy cancer cells. When used to treat MDS, a combination of drugs may be used. In general, chemotherapy has had limited success in treating MDS. One drug known as azacytidine, however, has been beneficial for some MDS patients. Chemotherapy may be given to a small number of MDS patients, particularly those at a high risk of developing AML.
  
  
• Angiogenesis inhibitors. Interfere with the growth of blood vessels which stimulate cancer growth. Some types of angiogenesis inhibitors have been shown to slow the progression of MDS in some patients.
  
  
• Differentiation agents. Cause immature bone marrow cells (blast cells) to mature. Some of these agents have proven useful in treating individuals with MDS.

In some MDS patients, including elderly patients who may also have additional medical disorders, bone marrow or stem cell transplant may not be a treatment option. In situations where no curative option is available, the goal of treatment may be to relieve symptoms and complications of the disease. Known as palliative or supportive therapy, these treatments may also be used to treat the symptoms and complications of patients with favorable outlooks as well. Treatment options that may be used to relieve or prevent the complications of MDS include:

• Blood transfusions. Blood or blood products are infused into the patient through a vein to replace blood cells destroyed by disease or treatment.
  
  
• Blood cell growth factors. Hematopoietic growth factors are hormone-like substances that stimulate blood cell production in the bone marrow. Growth factors, including erythropoietin and granulocyte colony stimulating factor (G-CSF), may be given to MDS patients to increase the number of blood cells and lessen the effects of anemia or frequent infections.
  
  
• Hormones. Proteins that control most body functions. Hormones, including glucocorticoids and androgens, may be given but are usually ineffective.
  
  
• Antibiotics. Because patients with MDS may have low white blood cell counts and may be more likely to develop an infection, antibiotics may be recommended to treat any known or suspected infections.

Following treatment, patients typically require regular follow-up visits to their physician. Frequent checkups enable the physician to detect any signs of infection or progression of the disease into leukemia. Follow-up exams also allow a physician to detect any short-term and long-term effects of treatment. Checkups may include a physical examination and laboratory tests of the blood and bone marrow.