Myelodysplastic syndrome treatment

International standards for the diagnosis and treatment of myelodysplastic syndrome

How is myelodysplastic syndrome diagnosed

Stage 1. The specialist prescribes a complete blood count.

This test is necessary to determine the number of erythrocytes, platelets and leukocytes, as well as to assess their structure and properties (size, shape, color, volume).

With MDS, levels of one, two, or all cell types are reduced. In addition, they may be irregular or resized.

Stage 2. Bone marrow aspiration and biopsy

Under anesthesia, a piece of bone marrow is extracted with a syringe, which is examined for the presence of the number of cells with pathological changes.

Stage 3. Chromosome analysis

An experienced doctor will order a chromosome test to learn about the genetic causes of MDS.

The doctor examines the structure of chromosomes, identifies or refutes the presence of genetic abnormalities.

Treatment of myelodysplastic syndrome

The choice of therapy is based on the patient’s clinical risk status. All known patient health information is used to calculate scores in the Revised International Predictive Scoring System for MDS.

There are 5 risk categories: very low, low, intermediate, high and very high.

Various treatment options are available today:

1. Waiting tactic,
2. Transfusion of blood components,
3. Drug treatment,
4. Therapy for high-risk patients.

To draw up an individual treatment plan, an experienced doctor of a leading foreign clinic studies the following criteria:

• General health,
• Patient age,
• MDS type,
• The presence of concomitant diseases,
• Clinical risk status according to the IPSS-R system.

Treatment options can be combined with each other and change over the course of the disease.

1. Waiting tactics:

This tactic is best for low-risk patients. It is necessary to visit an experienced doctor regularly to control the disease and be sure that there will be no imperceptible deterioration and sharp progression of MDS.

2. Transfusion of blood components:

The goal — to improve blood counts and oxygen uptake. Today it’s a safe procedure that relieves the signs of anemia.

With regular administration of erythrocytes, an excess of iron may occur. In this case, doctors prescribe medication to remove iron from the body.

3. Drug treatment:

Under certain conditions, MDS can be treated medically with artificial growth factors. They can be administered weekly to stimulate the production of healthy blood cells and platelets.

Valproic acid can be used in low-risk patients. This makes it possible to do without blood transfusion for several months.

Immunomodulation — stimulation of cells to divide and further transform into normal blood cells.

Immunosuppression — neutralization blasts before they enter the bloodstream.

4. Treatment for high-risk patients:

For the treatment of high-risk patients, in addition to the methods listed above, use:

• Demethylating agents — correct defects in the genetic material of the affected cells for their normal functioning,
• Chemotherapy — reduces the number of blasts and thus creates more room for mature cells.