Myelodysplastic Syndrome Treatment Approaches
Just as every patient is different, we recognize that every case of myelodysplasia is different. What distinguishes City of Hope in the treatment of myelodysplasia patients is seamless continuity of care. From a new diagnosis to treatment with the newest drugs within our extensive program of clinical trials to stem cell transplantation, patients are treated by the same team of doctors who see them through every phase of treatment and recovery.

City of Hope also offers the expertise of geriatric oncologists who specialize in the treatment of older patients and a comprehensive supportive care staff to help promote and maintain their well-being during and after the treatment.

Our patients are provided treatments based on the latest evidence available and up-to-date clinical guidelines. Factors that determine the therapy regimen include:

  • Type and risk level of disease
  • Prior therapies, if any
  • Patient’s characteristics, such as age and overall health
  • Choice of the patient and care provider, if multiple treatment options are available

Based on these factors, the myelodysplasia treatment regimen may include one or more of the following:

Tranfusion and Supportive Drug Therapy

Because myelodysplasia often depletes a patient of healthy blood cells, transfusion may be administered to restore blood cell counts to normal levels.
 
Additionally, growth factors may be administered to stimulate the body to produce more blood cells and antibiotics may be used to help the patient fight off infections.

Stem Cell Transplantation

City of Hope is a leader in the use of stem cell transplantation to treat myelodysplastic syndrome and other blood cancers. Since the program began in 1976, more than 12,000 transplants have been performed and it has been recognized for superior survival outcomes for nine consecutive years—the only transplant center in the United States with such an achievement.
 
Transplants are sometimes performed early in the course of treatment to improve long-term results or it may be utilized when other treatments are not working.
 
In this procedure, a patient undergoes intensive chemotherapy, and sometimes radiation therapy, to destroy the abnormal cells followed by an infusion of new stem cells. The stem cell transplant may be either autologous (extracted from the patient’s own body) or allogeneic (using stem cells taken from another person.) For patients with myelodysplastic syndrome, allogeneic transplants are preferred because an autologous transplant may contain abnormal, myelodysplasia-causing cells.

One known complication of allogeneic transplants is graft versus host disease (GvHD), in which the newly transplanted cells does not recognize the recipient’s body as their own and forms an immune response against it. City of Hope is on the forefront of tackling this side effect and is constantly improving allogeneic transplant protocols to reduce GvHD risk and impact.
 
Nonmyeloablative (Mini) Transplants
 
City of Hope physicians also specialize in “mini” stem cell transplants for patients who cannot tolerate the side effects associated with a standard stem cell transplantation, such as older patients or patients with other medical conditions. These transplants rely less on the heavy doses of chemotherapy and radiation and more on the effects of the graft itself. This novel approach allows patients who are otherwise ineligible, including patients in their 70s, to be treated with this lifesaving procedure.

Chemotherapy

Chemotherapy, or the use of cancer-fighting drugs, may be used in treating myelodysplasia, particularly those that are at risk for developing into leukemia. Chemotherapy is usually given in cycles, with breaks in between to allow patients to recover from side effects.

Standard chemotherapy drugs used for treat myelodysplasia are similar to those used to treat acute myeloid leukemia. The regimen may include one or more of the following:
  • Azacitidine (Vidaza®)
  • Cytarabine (Cytosar-U®)
  • Decitabine (Dacogen®)
  • Fludarabine (Fludara®)
  • Idarubicin (Idamycin®)
  • Lenalidomine (Revlimid®)
  • Thalidomide (Thalomid®)
  • Topotecan (Hycamtin®)
 
Additionally, City of Hope researchers and clinicians are constantly developing new regimens to improve the effectiveness of existing drugs or building new drugs that are more powerful against myelodysplastic syndrome disorders.

Radiation

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. Our Helical TomoTherapy System® reduces the unwanted exposure of normal tissues and reduces potential complications. The system combines radiation delivery with real-time imaging, allowing doctors to deliver a higher dose of radiation with greater precision. This significantly improves outcomes and reduces side effects compared to traditional whole-body irradiation, which unnecessarily exposes healthy tissues.

How to Become a Patient

If you have been diagnosed with a myelodysplastic syndrome disorder or are looking for a second opinion consultation about your treatment, find out more about  becoming a patient or contact us at 800-826-HOPE.