Watchful Waiting for Myelodysplastic Syndromes

NYU Langone doctors may recommend delaying treatment for a myelodysplastic syndrome if you are not experiencing symptoms, and if tests show that the condition is at a low risk of progressing to acute myeloid leukemia, or AML.

Instead, specialists regularly check blood cell levels and assess your symptoms. This process is called watchful waiting and can last for several years. However, at some point, the condition typically worsens and causes symptoms that require treatment.

People with low-risk myelodysplastic syndromes can have decreased levels of red blood cells, white blood cells, or platelets. However, these levels typically aren’t low enough to cause symptoms, such as weakness and fatigue, infection, or problems with bleeding or bruising.

Watchful waiting requires blood testing to check levels of blood cells. NYU Langone experts also check whether blasts, which should only be present in the bone marrow, are circulating in the bloodstream. Occasional bone marrow biopsies may also be necessary if doctors suspect the syndrome is progressing. Your doctor determines the schedule for this testing.

If signs and symptoms of more aggressive myelodysplastic syndrome become apparent, doctors recommend starting treatment.