Welcome to the Forum, Arcadi
As you probably know, RARS is a subtype of MDS having – generally speaking – relatively favourable prognosis. Median survival from the time of diagnosis is ca 4 years, but – as the biology of the disease is inconsistent – it may vary.
Much depends on the cytogenetics – but only every fifth patient have changes in his karyotype. No abnormal chromosomes mean favourable prognosis.
Only ca 5% of RARS progress to acute leukemia.
In a MDS patient every fever, every cold should be considered as a potential medical emergency and should be consulted with a doctor immediately.
Patients with MDS should have their CBCs/blood smears evaluated quite regularly to monitor their blood cell counts.
Even satisfactory levels of blood cells might in particular patients be not enough because the defects in their maturation and differentiation make them infunctional.
Referring to the other alternatives you asked about I would need some more detailed data on the blood smears and bone marrow biopsies.
Vidaza is of course an option, but it is more probable to work on RAEB patients.
Erythropoietin (EPO, Procrit) is an option especially in early stages of disease and when serum EPO levels fall below 200 U/l.
Thalidomide is an experimantal agent in context of MDS and appears to be a good choice of your father’s doctor. It works on every fifth patient to show complete response. Patients with refractory anemia or refractory anemia with ringed sideroblasts in the early phase of disease demonstrated a better response than those with more advanced disease. Responses included the correction of anemia and/or increased platelet and neutrophil counts.
If the disease progresses and your father’s health allows it, I would think about a transplant option in case a perfect matched donor was avaiable. Prof. Mufti’s outcomes at King College England (Greg posted the specific ‘Blood’ Journal link) seem to be very promising.
Best wishes for you and your father
Take care
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