What Is Watch And Wait in MDS?

Myelodysplastic syndromes (MDS) are a group of blood disorders that affect how bone marrow makes blood cells. They can lead to low blood cell counts (cytopenia) and the inability of bone marrow cells to develop properly (dysplasia). 

Dr. Choi explains the watch-and-wait approach, which involves observing a patient’s progress, analyzing the MDS genetics, and deciding on a tailored treatment to better control progression. 

MDS patients are classified according to the risk of their disease progressing into acute leukemia. The therapies administered and treatment goals will be adapted to that risk: 

• Low-risk patients, doctors will try to minimize symptoms with medication as much as possible. 
• High-risk patients, treatment options will be more aggressive, like a bone marrow transplant, to try to control the underlying disease for as long as possible. 

The decision to start treatment or not is based not only on side effects and progression risk but also on the patient’s benefit from receiving it. The reasoning is thinking long-term about how much the patient’s prognosis can change by having treatment versus not having any. If the change is not significant, it could be a better option to monitor the disease closely and guarantee a good quality of life. 

Your doctor will discuss with you the frequency of your checkups and any tests needed to ensure that your disease is stable. If you notice any changes between appointments, it is important that you notify your medical team as soon as possible.

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