*Please note: This slide show represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.
Treatment for MDS-related anemia depends on what type of MDS you have, your general health, your age, and what you want for the future.
It also depends on whether the MDS has a low, medium or high risk of becoming acute myeloid leukemia, or AML. About 30 percent of people with MDS develop this life-threatening blood cancer.
The main treatments for MDS are designed to reduce your symptoms, slow down or prevent the development of AML, and help you live longer.
A bone marrow, or stem cell, transplant is the only curative treatment for MDS.
Supportive care will be a major part of your treatment. This is the medical term for care that relieves symptoms, treats complications, or problems, and helps your body make more blood cells to replace abnormal ones.
Supportive care for MDS-related anemia often includes receiving blood from a healthy donor in a procedure called a blood transfusion.
The donated blood raises the number of red cells in your blood. It also raises the level of a protein called hemoglobin in these cells.
Hemoglobin carries oxygen, so raising it can relieve anemia symptoms such as feeling very tired or short of breath.
However, transfusions do not work well for everyone. Frequent transfusions can cause a condition called iron overload. Extra iron can build up in your body from the transfused red blood cells. Too much iron can harm your heart, liver, and a digestive organ called the pancreas.
Your doctor will check your level of ferritin, or stored iron, regularly. If too much iron builds up, you might need a treatment called chelation to remove the extra iron.
A single transfusion will only increase your red blood cell count for a short while. Transfusions are often required every few weeks.
If you need transfusions more and more often to keep enough red cells in your bloodstream, you might have a condition called transfusion-dependent anemia.
If you do not need transfusions very often or at all, your anemia might be transfusion-independent. You might still have a low red cell count but you do not need frequent transfusions to avoid severe anemia.
You will have your blood counts checked often, including after transfusions.
Reading your blood test results can be confusing. The letters R-B-C stand for red blood cells. This line shows your total red blood cell count.
H-G-B stands for hemoglobin, the protein in red blood cells that carries oxygen.
And H-C-T stands for hematocrit, the percentage of red cells in your blood.
Transfusions are not always the first treatment you receive. Your doctor might prescribe medicines that help the bone marrow make more red blood cells.
These medicines are called erythropoiesis stimulating agents, or ESAs. Your doctor might prescribe these medicines as soon as you learn you have MDS, or later if your anemia gets worse over time.
ESAs are given as a shot. Two ESAs are currently approved in the United States: Epoetin alfa and darbepoetin.
Doctors can add a medicine called G-CSF if ESAs do not work well alone. G-CSF helps the bone marrow make more immature blood cells called progenitors, which can turn into red blood cells.
Some patients might take a medicine called lenalidomide at the same time. Ask your doctor about all your medication options.
Other medicines include romiplostim and eltrombopag. They are not yet officially approved to treat MDS, but have been studied and can be used.
These drugs help your bone marrow make more platelets, the cells that help blood clot, so you may take them if you have MDS.
The medicines azacitidine and decitabine turn on genes that have stopped working normally, allowing your own body to fight MDS. They are given as an injection under the skin or into a vein, every month for 5 to 7 days in a row.
Cytarabine is one chemotherapy drug used to treat AML, the life-threatening blood cancer that MDS can turn into. Other chemotherapy drugs include daunorubicin, venetoclax and glasdegib.
Researchers are developing new MDS medicines in clinical trials.
A medicine called luspatercept can help red blood cells mature in greater numbers, as they do in someone without MDS. This medicine is not yet approved for the public.
A medicine called roxadustat helps your body make more of its own erythropoietin, a hormone that stimulates red blood cell production.
Roxadustat is approved for use in China and may soon be available elsewhere.
Bone marrow transplant, or BMT, is a treatment that gives you healthy blood stem cells that destroy and replace your abnormal bone marrow. Another name for it is stem cell transplant.
This is the only treatment that can cure MDS, although it does not work for everyone. It is too risky for some patients, because it can cause life-threatening complications.
Your doctor will tell you if BMT is an option. Your heart, lungs, liver, and kidneys should be healthy, and you should be able to do daily activities independently. BMT is often considered for people with high risk disease.
You can have BMT up to 75 years of age or possibly older if you are healthy enough. People without certain gene mutations tend to do better after BMT.
Staying in close touch with your doctor can help you get the best treatment and live longer with fewer symptoms.
Tell your doctor about any new symptoms or concerns, follow your treatment plan, and ask what else is available if your current treatment is not working as well as you would like.
New treatments are being developed to help people live longer, better lives with MDS.