NCCN Guidelines for Patients® | Myelodysplastic Syndromes
32 NCCN Guidelines for Patients ® : Myelodysplastic Syndromes, 2018 4 Cancer treatments Immunotherapy Guide 4. Drug treatments for MDS Generic name Brand name (sold as) Type of drug Azacitidine Vidaza® Chemotherapy (low-intensity) Decitabine Dacogen® Chemotherapy (low-intensity) Imatinib mesylate Gleevec ® Targeted therapy ATG ( a nti- t hymocyte g lobulin, equine) Atgam® Immunosuppressive therapy Cyclosporine Neoral®, Sandimmune® Immunosuppressive therapy Lenalidomide Revlimid® Immunomodulator Most of the high-intensity drugs are given as IV infusions. If you will have high-intensity chemo, ask your doctor about the combination of drugs given, how many cycles are needed, and how many days of treatment are in each cycle. Side effects of chemotherapy A side effect is an unhealthy or unpleasant physical or emotional condition caused by treatment. Each treatment for MDS can cause side effects. The reactions to chemotherapy differ between people. Some people have many side effects. Others have few. Some side effects can be very serious while others can be unpleasant but not serious. Most side effects appear soon after treatment starts and will go away after treatment ends. But, other side effects are long-term and may appear years later. The side effects of chemotherapy depend on many factors. This includes the drug, the dose, and the person. In general, side effects are caused by the death of fast-growing cells, which are found in the intestines, mouth, and blood. Thus, common side effects of chemotherapy are nausea, vomiting, diarrhea, not feeling hungry, hair loss, and low blood cell counts. Not all side effects of chemotherapy are listed here. Be sure to ask your treatment team for a complete list of common and rare side effects. If a side effect bothers you, tell your treatment team. There may be ways to help you feel better. There are also ways to prevent some side effects. Immunotherapy The immune system is the body’s natural defense against infection and disease. Immunotherapy is treatment with drugs that use the immune system to help the body fight cancer. Different types of immunotherapy drugs affect the immune system in different ways. The two types of immunotherapy that may be used to treat MDS are described next. Immunosuppressive therapy IST ( i mmuno s uppressive t herapy) is the use of drugs that lower (suppress) parts of the immune system. In some types of MDS, the immune system may attack the bone marrow by mistake. This can cause the bone marrow to not work well and not make enough blood cells. IST drugs help to stop the immune system from attacking the bone marrow.