NCCN Guidelines for Patients® | Myelodysplastic Syndromes

28 NCCN Guidelines for Patients ® : Myelodysplastic Syndromes, 2018 4 Cancer treatments Supportive care Part 4 describes the main types of treatment for MDS. Knowing what a treatment is will help you understand your treatment options listed in the Treatment guide in Part 5. There is more than one treatment for MDS. Not every person will receive every treatment listed in this chapter. Supportive care Supportive care is treatment given to relieve the symptoms caused by cancer and side effects of cancer treatment. It doesn’t treat the cancer itself. The goal of supportive care is to improve quality of life and relieve any discomfort you may have. Supportive care is an important part of the overall treatment for MDS. It can address many needs. One example is treatment for physical and emotional symptoms. It can also help with treatment decisions and coordination between health care providers. Low blood cell counts are very common in patients with MDS. Low blood counts can be a low number of red blood cells (anemia), a low number of platelets (thrombocytopenia), or a low number of white blood cells (neutropenia). Some patients may have only one of these, while others may have all three. Low blood cell counts can cause many symptoms and affect quality of life. Thus, supportive care is often aimed at improving these low blood cell counts to lessen the related symptoms. The main types of supportive care that are used for MDS are described next. Blood transfusions A blood transfusion is a slow injection of red blood cells into a vein. A red blood cell transfusion may be used to treat anemia that is causing symptoms. Symptoms of anemia include tiredness and shortness of breath. A red blood cell transfusion can help to relieve these symptoms for a short time. Normal red blood cells live about 3 months, but transfused red blood cells last a much shorter time. More transfusions may be needed over time. Most patients with MDS will need one or more red blood cell transfusions at some point. There is no maximum number of red blood cell transfusions a patient may receive. Once a patient has had more than 20 red blood cell transfusions, it may be necessary to think about removing iron (which is carried in red blood cells). Thrombocytopenia can cause symptoms such as easy bruising or bleeding. A platelet transfusion may be used to treat bleeding problems. There is no maximum number of platelet transfusions a patient may receive. Transfused platelets usually live less than a week, and some patients with low platelets may require transfusions regularly. Iron chelation therapy Iron is a mineral found in red blood cells. Receiving a large number of red blood cell transfusions can cause too much iron to build up in the body. This is called iron overload. Excess iron can collect in and damage organs such as the heart, liver, and pancreas. Iron chelation therapy is used to treat iron overload. It is the use of drugs—called iron chelators—that bind to excess iron to remove it from the body. Deferoxamine and deferasirox are iron chelators that may be used for patients with MDS.