NCCN Guidelines for Patients® | Myelodysplastic Syndromes
47 NCCN Guidelines for Patients ® : Myelodysplastic Syndromes, 2018 5 Treatment guide Higher-risk MDS If an allogeneic HCT is not a good option for you or a donor hasn’t been found, there are three options to choose from. The first option is to receive azacitidine, a low-intensity chemotherapy drug. This is the preferred option for patients with higher-risk MDS who are not able to have high-intensity treatment. Azacitidine can lower the chance that MDS will progress to AML in some patients. It can also help some patients have improved blood cell counts and live longer than they would without treatment. Your doctor may refer to this as “improved survival.” The second option is to receive decitabine, which is also a low-intensity chemotherapy drug. It is a lot like azacitidine in how it works against MDS. Decitabine can lower the chance that MDS will progress to AML in some patients. The third option is to receive treatment within a clinical trial. Next steps See Guide 9 on page 48 for the next options after initial treatment for higher-risk MDS.