Support Treatment to Improve Daily Living with MDS

Myelodysplastic syndromes (MDS) are a group of disorders caused by poorly formed or dysfunctional blood cells in the bone marrow. Managing MDS involves a combination of supportive care and active treatments. 

Supportive care is essential in MDS treatment. It helps manage symptoms, prevent complications, and improve a patient's well-being. Supportive care may be the primary treatment for some patients, especially those with lower-risk MDS.

An expert discussion from the American Journal of Managed Care covered the supportive care needs of MDS patients. The discussion featured experts Ryan Haumschild, PharmD, MS, MBA, the Vice President of Pharmacy at Emory Health, and  Amer Zeidan, MBBS, MHS, an associate professor of medicine (hematology) at Yale University.

In this article, we will cover the main points of discussion from experts to provide you with comprehensive information on supportive care. 

What Are the Supportive Care Needs for MDS Patients? 

• Transfusions: Anemia (low counts of red blood cells) is a common symptom in 90% of MDS patients, and sometimes, it’s so severe that a person constantly requires blood transfusions to maintain the optimal amount of blood cells and oxygen circulating. 
• Treatments to prevent or manage infections: If the white blood cells are low or you are taking a treatment that lowers the body’s immune responses, it’s common to have infections. Depending on the white blood cell levels, these can be mild to life-threatening, so it's crucial to be vaccinated and have adequate treatment to control or prevent infections. 
• Growth factors are treatments designed to stimulate healthy blood cell production. Some can help produce red blood cells (erythropoiesis-stimulating agents), but their effects are not immediate and can take up to four months to produce significant changes. Others help boost white blood cells (Granulocyte-Colony Stimulating Factor) or platelets (Eltrombopag) 
• Iron chelation therapy: patients who often need transfusions commonly have an iron overload that can damage vital organs. Iron chelation therapy safely removes excess iron from the body. However, it must be closely monitored because some patients may not tolerate it. Read our article covering iron chelation therapy. 

When to Stop Supportive Care? 

Supportive care can initially be the only treatment option for some patients for symptom management, but when the disease progresses, supportive care will be secondary to chemotherapy or transplant, which are given to address the disease itself. 

It is important to understand that supportive care alone may not be enough for all patients. For example, for those with lower-risk MDS, additional therapies might be needed as the disease progresses. For higher-risk MDS patients, active therapy is often initiated from the start, alongside supportive care measures. 

It is crucial that patients and caregivers know and understand their options for supportive care since it is a pillar of MDS management and can significantly improve a patient's quality of life. When tailoring care according to your needs, your medical team should offer a 360-degree approach, including transfusions and iron chelation, infection prevention, and growth factors administration, to ensure the best possible outcomes.

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