• Managing the Side Effects of Myelodysplastic Syndrome (MDS) and MDS Treatment

    The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
    Medications may help to either prevent or reduce side effects of treatment, or to manage certain side effects once they occur. Since you can develop these symptoms from the treatment and/or from the disease itself, it is essential that you discuss them with your doctor when you notice and ask him or her if any of these medications are appropriate for you.
    MDS produces symptoms indirectly because it alters the blood counts. These indirect symptoms include the following:
    • Fatigue
    • Susceptibility to infection
    • Bruising
    • Enlargement of the spleen
    • Occasional discomfort
    • Loss of appetite
    Indirect symptoms can be managed with antibiotics, pain medications, CNS stimulants (for the treatment of fatigue) and blood products, as explained here. If the symptoms are severe and persistent you may need to consider a meeting with a palliative care doctor.

    Antibiotics

    Because impaired immunity can result from MDS, you are at high risk for infections. Your doctor will monitor you for infections and prescribe antibiotics as appropriate. Take care to avoid situations that can lead to increased risk of infection through the skin or respiratory passages. Prophylactic use of antibiotics is not routinely utilized.

    Blood Products

    The most common supportive care for MDS involves the use of transfused blood components. Packed red blood cell transfusions are necessary for treatment of anemia. Platelet transfusions are reserved for severely depressed platelet counts to prevent bruising or bleeding, or for patients who have bruising or bleeding with mildly or moderately depressed platelet counts.
    While transfusions are usually safe, there is a very low risk of contracting a serious infection. Of more concern is the development of resistance to the benefits of transfusion by repeated exposure to blood products and the development of antibodies. Thus, transfusions should be used as often as thought to be safe.

    References

    Castro-Malaspina H, O’Reilly RJ. Aplastic anemia and the myelodysplastic syndromes. In: Kasper DL, Harrison TR. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

    Silverman LR. Myelodysplastic syndrome. American Cancer Society website. Available at: http://www.nci.nih.gov/cancer%5Finformation/ . Accessed November 30, 2002.

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