Groshan Fabiola

Considered to be a benign disease for years, Myelodysplastic Syndrome (MDS) is nowadays known to pose a serious threat to people it affects. Recent studies have revealed that MDS is actually a malignant disease that can further lead to leukemia. Due to this fact, Myelodysplastic Syndrome is also referred to as pre-leukemia disease.

Similar to leukemia, MDS triggers an overproduction of abnormal blood cells that eventually outnumber their healthy counterparts. The cells involved in causing the disease are called blasts and they originate in the bone marrow. Dysfunctional blasts multiply at abnormally fast rates and accumulate in the marrow or in the bloodstream. These functionless cells perturb the production of normal blood cells, causing a decrease in the number of red blood cells, white blood cells and platelets. As a result, people who suffer from MDS also have anemia, (due to fewer red blood cells), impaired immune system (due to fewer white blood cells) and experience slow healing (due to fewer platelets).

Many patients diagnosed with MDS are at risk of developing leukemia. In order to block the progression of MDS and to prevent the occurrence of leukemia, most patients receive treatments with decitabine, a new drug that is currently under testing.

Although most patients diagnosed with MDS respond well to treatments with mild chemotherapy drugs and decitabine, they commonly experience relapse after completing the prescribed course of medications. MDS has a pronounced recurrent character and despite its high curability in the initial stages of the disease, it becomes very difficult to treat in later stages of evolution.

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Oncologists have noticed the fact that patients who relapse also become less responsive to second treatments. The exact reasons why most patients with MDS fail to respond to re-treatment are still unknown. However, this problem may be corrected by extending the duration of initial treatments. Medical scientists explain that a single long-term course of chemotherapy drugs and decitabine may provide better results than frequently repeated shorter treatments. They sustain that by extending the treatment with mild chemotherapy drugs and decitabine beyond the margin of remission, patients with MDS are less likely to relapse. In addition, medical scientists claim that patients who achieve remission should follow ongoing maintenance treatments in order to prevent the recurrence of the disease.

Recently conducted experiments have confirmed the fact that long-term treatments provide better results than repeated treatments in overcoming MDS. Patients who receive short-term treatments not only experience relapse, but they are also more exposed to developing acute leukemia and other severe forms of blood cancer. In order to prevent this from happening, an extended low-dose initial treatment with decitabine followed by maintenance treatments may be the best option for patients diagnosed with MDS.