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Information from PDQ for Patients
Myelodysplastic syndromes
208/02495
** DESCRIPTION **
-- What are myelodysplastic syndromes? --
Myelodysplastic syndromes, also called pre-leukemia or "smoldering" leukemia,
are diseases in which the bone marrow does not function normally and not enough
normal blood cells are made. The bone marrow is the spongy tissue inside the
large bones in the body. The bone marrow makes red blood cells (which carry
oxygen and other materials to all tissues of the body), white blood cells
(which fight infection), and platelets (which make the blood clot). Normally,
bone marrow cells called blasts develop (mature) into several different types
of blood cells that have specific jobs in the body.
Myelodysplastic syndromes occur most often in older people, but they can occur
in younger people. The most common sign is anemia, which means there are too
few mature red blood cells to carry oxygen. There may also be too few white
blood cells in the blood to fight infections. If the number of platelets in
the blood is lower than normal, this may cause people to bleed or bruise more
easily. A doctor should be seen if a person bleeds without any reason, bruises
more easily than normal, has an infection that won't go away, or feels tired
all the time.
If there are symptoms, a doctor may order blood tests to count the number of
each kind of blood cell. If the results of the blood test are not normal, the
doctor may do a bone marrow biopsy. During this test, a needle is inserted
into a bone and a small amount of bone marrow is taken out and looked at under
the microscope. The doctor can then determine the kind of disease and plan the
best treatment.
A myelodysplastic syndrome may develop following treatment with drugs or
radiation therapy for other diseases, or it may develop without any known
cause. The myelodysplastic syndromes may change into acute myeloid leukemia, a
form of cancer in which too many white blood cells are made.
Myelodysplastic syndromes are grouped together based on how the bone marrow
cells and blood cells look under a microscope. There are five types of
myelodysplastic syndromes: refractory anemia, refractory anemia with ringed
sideroblasts, refractory anemia with excess blasts, refractory anemia with
excess blasts in transformation, and chronic myelomonocytic leukemia.
** STAGE EXPLANATION **
-- Stages of myelodysplastic syndromes --
There is no staging for the myelodysplastic syndromes. Treatment depends on
whether or not the disease developed following other treatments, or whether the
patient has been treated for the myelodysplastic syndrome. Myelodysplastic
syndromes are grouped as follows:
-- De novo myelodysplastic syndromes --
De novo myelodysplastic syndromes develop without any known cause. The patient
has not received radiation therapy or chemotherapy for other diseases.
-- Secondary myelodysplastic syndromes --
Secondary myelodysplastic syndromes develop following treatment with radiation
therapy or chemotherapy for other diseases.
-- Previously treated myelodysplastic syndromes --
Previously treated myelodysplastic syndrome means the disease has been treated
but has gotten worse.
** TREATMENT OPTION OVERVIEW **
-- How myelodysplastic syndromes are treated --
There are treatments for all patients with myelodysplastic syndromes. Often
the main treatment is giving red blood cells or platelets by a needle in a vein
(transfusion) to control anemia or bleeding. Vitamins or other drugs may also
be given to treat anemia.
Chemotherapy and biological therapy are being tested in clinical trials.
Chemotherapy uses drugs to treat disease. Chemotherapy may be taken by pill,
or it may be put into the body by a needle in the vein or muscle. Chemotherapy
is called a systemic treatment because the drug enters the bloodstream, travels
through the body, and affects cells throughout the body. Biological therapy
tries to get the body to fight disease. It uses materials made by the body or
made in a laboratory to boost, direct, or restore the body's natural defenses
against disease. Biological therapy is sometimes called biological response
modifier (BRM) therapy or immunotherapy.
Bone marrow transplantation is a newer type of treatment that uses high doses
of chemotherapy and/or radiation therapy (high doses of x-rays or other
high-energy rays) to destroy all of the bone marrow in the body, then
transplants healthy bone marrow back into the body. Healthy marrow is then
taken from another person (a donor) whose tissue is the same or almost the same
as the patient's. The donor may be a twin (the best match), a brother, sister,
or other relative, or another person not related. The healthy marrow is given
to the patient through a needle in the vein, and the marrow replaces the marrow
that was destroyed. A bone marrow transplant using marrow from a relative or
person not related to the patient is called an allogeneic bone marrow
transplant.
-- Treatment by stage --
The choice of treatment depends on the type of myelodysplastic syndrome, and
the patient's age and general health.
Standard treatment may be considered because of its effectiveness in patients
in past studies, or participation in a clinical trial may be considered. Most
patients with myelodysplastic syndromes are not cured with standard therapy and
some standard treatments may have more side effects than are desired. For
these reasons, clinical trials are designed to find better ways to treat cancer
patients and are based on the most up-to-date information. Clinical trials are
ongoing in most parts of the country for patients with myelodysplastic
syndromes. To learn more about clinical trials, call the Cancer Information
Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
** DE NOVO MYELODYSPLASTIC SYNDROME **
Treatment may be one of the following:
1. Treatment to relieve symptoms of the disease, such as anemia or bleeding.
2. Allogeneic bone marrow transplantation.
3. Clinical trials of chemotherapy or biological therapy.
** SECONDARY MYELODYSPLASTIC SYNDROME **
Patients will probably receive treatment to relieve symptoms of the disease,
such as anemia or bleeding. They may also choose to take part in a clinical
trial of chemotherapy or biological therapy.
** PREVIOUSLY TREATED MYELODYSPLASTIC SYNDROME **
Patients will probably receive treatment to relieve symptoms of the disease,
such as anemia or bleeding. They may also choose to take part in a clinical
trial of chemotherapy or biological therapy.
** TO LEARN MORE **
Call
For more information, U.S. residents may call the National Cancer Institute's
(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237)
Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing
callers with TTY equipment may call 1-800-332-8615. The call is free and a
trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI's Cancer.gov Web site (http://cancer.gov) provides online access to
information on cancer, clinical trials, and other Web sites and organizations
that offer support and resources for cancer patients and their families. There
are also many other places where people can get materials and information about
cancer treatment and services. Local hospitals may have information on local
and regional agencies that offer information about finances, getting to and
from treatment, receiving care at home, and dealing with problems associated
with cancer treatment.
Publications
The NCI has booklets and other materials for patients, health professionals,
and the public. These publications discuss types of cancer, methods of cancer
treatment, coping with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention, cancer
statistics, and NCI research activities. NCI materials on these and other
topics may be ordered online or printed directly from the NCI Publications
Locator (https://cissecure.nci.nih.gov/ncipubs). These materials can also be
ordered by telephone from the Cancer Information Service toll-free at
1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
LiveHelp
The NCI's LiveHelp service, a program available on several of the Institute's
Web sites, provides Internet users with the ability to chat online with an
Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m.
Eastern time, Monday through Friday. Information Specialists can help Internet
users find information on NCI Web sites and answer questions about cancer.
Write
For more information from the NCI, please write to this address:
National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
** ABOUT PDQ **
PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information
database. Most of the information contained in PDQ is available online at
Cancer.gov (http://cancer.gov), the NCI's Web site. PDQ is provided as a
service of the NCI. The NCI is part of the National Institutes of Health, the
federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on
cancer prevention, detection, genetics, treatment, supportive care, and
complementary and alternative medicine. Most summaries are available in two
versions. The health professional versions provide detailed information
written in technical language. The patient versions are written in
easy-to-understand, non-technical language. Both versions provide current and
accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and
reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are
responsible for writing and maintaining the cancer information summaries. The
summaries are reviewed regularly and changes are made as new information
becomes available. The date on each summary ("Date Last Modified") indicates
the time of the most recent change.
PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a
clinical trial. A clinical trial is a study to answer a scientific question,
such as whether one treatment is better than another. Trials are based on past
studies and what has been learned in the laboratory. Each trial answers
certain scientific questions in order to find new and better ways to help
cancer patients. During treatment clinical trials, information is collected
about new treatments, the risks involved, and how well they do or do not work.
If a clinical trial shows that a new treatment is better than one currently
being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at
Cancer.gov (http://cancer.gov/clinical_trials). Descriptions of the trials are
available in health professional and patient versions. Many cancer doctors who
take part in clinical trials are also listed in PDQ. For more information,
call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at
1-800-332-8615.
Date Last Modified: 09/2002
******************************************************************************
* If you want to know more about cancer and how it is treated, or if you *
* if you wish to know about clinical trials for your type of cancer, you *
* can call the NCI's Cancer Information Service at 1-800-422-6237, toll *
* free. A trained information specialist can talk with you and answer *
* your questions. *
******************************************************************************
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This information has been brought to you by
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