Patients with severe or advanced MDS may be treated with bone marrow transplantation (hematopoietic cell transplantation.). This is currently the only type of treatment that has the potential to cure MDS. In some groups of patients with MDS, the success rate (how many people are cured of their disease) is as high as 70 to 75 percent. Some of these patients have now been followed for 25 years or longer by their healthcare teams, with no sign that the disease has returned.
MDS patients have allogeneic transplants (using stem cells from a donor). First they have chemotherapy designed to kill diseased stem cells in their marrow. This is called conditioning. Some have myeloablative conditioning, which completely destroys their bone marrow and immune system. Others have low-dose conditioning, called a non-myeloablative transplant or mini-transplant. The low-dose conditioning destroys some of your bone marrow cells. The intent is to suppress your immune system enough that the donor cells are not rejected and they can help to kill remaining abnormal cells in your marrow by an immune attack on those cells.
A transplant is not appropriate for everyone. For instance, a transplant may be too challenging for older people, especially if they have other health problems besides MDS, as many older people do. Though some people have had successful transplants at age 70, a transplant is not the standard treatment in this age group.
For some people who cannot undergo a myeloablative transplant, a non-myeloablative transplant may be an option. It is less toxic, and the side effects are generally milder. This option was developed in the late 1990s by Rainer F. Storb, MD, and colleagues at Fred Hutch.
Read more about our Transplant Program.