My younger ways have caught up with me and now I suffer. I have non-alcoholic cyrhosis. and just recently had 29 esophageal varicees banded to stop the blood loss.
Over the last 3 years 6 hospital stays of 5 days each and 6-7 units of blood transfusion each time.
Answer:
The goals of therapy are to control symptoms, improve quality of life, improve overall survival, and decrease progression to acute myelogenous leukemia.
The IPSS scoring system can help triage patients for more aggressive treatment (i.e. bone marrow transplant) as well as help determine the best timing of this therapy.[2] Supportive care with blood product support and hematopoeitic growth factors (e.g. erythropoietin) is the mainstay of therapy.
Three agents have been approved by the US FDA for the treatment of MDS: 5-azacytidine, decitabine, and lenalidomide. Chemotherapy with the hypomethylating agents 5-azacytidine and decitabine has been shown to decrease blood transfusion requirements and to retard the progression of MDS to AML. Lenalidomide was approved by the FDA in December 2005 only for use in the 5q- syndrome.
Bone marrow transplant, particularly in younger patients (ie less than 40 years of age), more severely affected patients, offers the potential for curative therapy. Success of bone marrow transplantation has been found to correlate with severity of MDS as determined by the IPSS score, with patients having a more favorable IPSS score tending to have a more favorable outcome with transplantation.[
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