Chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment, meaning the drugs travel throughout the entire body. This means chemotherapy may reach every cell in the body.
Many people with MDS do not require chemotherapy treatment other than supportive treatments such as intermittent transfusions. However, at times chemotherapy may be required if no other options exist.
- Cytosine arabinoside (Cytarabine)
- Azacytidine (Ladakamycin)
- Topotecan (Hycamtin)
- Fludarabine (Fludara)
- Idarubicin (Idamycin)
These agents have been used alone, in combination with other anticancer drugs, and with drugs in other categories, such as hematopoietic growth factors. No consensus has been achieved and no improvement in the ultimate outcome has been realized except with a new experimental drug called
AzaC.
Recently,
thalidomide
has been used in people with MDS. One study has suggested that transfusion requirements may diminish in patients with certain subtypes of MDS treated with thalidomide.
A number of anti-leukemia chemotherapy regimens have induced short-term remissions in as many as 60% of people with MDS, but at substantial risk. The length of these intensive treatment regimens may run between six and nine months. Aggressive anti-leukemia treatment schedules produce a mortality rate up to 30%. Less aggressive programs are suitable for some patients, but again the responses are brief.
This form of treatment may benefit patients who are candidates for
bone marrow transplant (BMT). Only BMT and AzaC appear to improve overall survival or change the natural history of the disease at this time.
Low-dose chemotherapy treatment may briefly benefit certain classes of patients, such as the elderly, by exposing them to lower risk.
Side effects of chemotherapy for MDS are identical to those seen in leukemia and other forms of cancer. The only unique aspect of treating MDS is the advanced age of the patients, which makes many side effects more likely and more dangerous.
Last reviewed July 2007 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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