What is Myelodysplastic Syndrome (MDS)?A myelodysplastic syndrome is a rare group of cancer cell disorder in which a group of immature cells formed in the bone marrow do not mature or become healthy blood cells. The myelodysplastic disorder is also called “bone marrow failure disorder”. MDS affects people with age >60years and is seen as more common in men than women. However, it can be seen in the younger age group also. Picture Courtesy: Blood cancer
What are the most common risk factors associated with Myelodysplastic Syndrome?
- People who get exposed to chemicals such as benzene and toluene can frequently have a risk of this disease.
- Anemia patients
- Affects people of older age group (>60years)
- People who underwent chemotherapy or radiotherapy previously.
- Tobacco usage
- People diagnosed with inherited diseases such as Down syndrome, Fanconi anemia, Bloom syndrome, Ataxia telangiectasia, etc.
- People suffering from other blood disorders have an increased risk of MDS, such as Paroxysmal nocturnal hemoglobinuria and congenital neutropenia.
Complications of Myelodysplastic Syndrome MDS
- Affects the nervous and immune systems.
- Infections due to decreased WBC.
- Recurrent bleeding due to lack of platelets.
- Increased risk of cancer.
- The posture and balance of the body while performing certain activities suddenly become unstable.
Myelodysplastic Syndrome TreatmentBefore stepping into the treatment procedure doctor observes some undeniable factors in a patient, such as the age of a person, apart from Myelodysplasia, how many other diseases the patient carries, if there is any bone marrow transplant donor then, whether that person is capable of undergoing transplantation and stage of Myelodysplasia. Different types of treatment are available for patients with myelodysplastic syndromes. Treatment includes supportive care, drug therapy, and chemotherapy with a stem cell transplant.
1. Supportive care includes:Iron Chelation – Helps to remove unwanted iron from the body and normalizes the mineral content in the body. Blood Transfusion – This maintains the blood counts, and if someone has less RBC, WBC, and platelets, it sort of increases until it gets normal. Erythropoiesis-stimulating agents- are used to improve anemia in patients with MDS by increasing the production of some mature red blood cells.
2. Medications for Myelodysplastic SyndromeMedicines such as Decogen and Vidaza relieve symptoms of Myelodysplasia and increase the count of healthy cells. Revlimid stops the involvement of gene mutation. Immunosuppressive stops the immune system from spreading immature cells to bone marrow. Growth factors – Some growth factors can replace the requirement of Blood transfusions, such as Zarxio, Procrit, and Neupogen Antibiotic therapy- is used in fighting against infections.
3. Chemotherapy with stem cell transplantPicture Courtesy: cancer.gov Stem cell transplant. (Step 1): The doctor collects blood from a vein in the arm of the donor. The donor can be either the patient or another person. The removal of the stem cells is done by a machine where the blood flows through. Then, through a vein in the other arm, the blood is returned to the donor. (Step 2): To kill blood-forming cells, the patient receives chemotherapy. The patient may receive radiation therapy (not shown). (Step 3): A catheter is placed into a blood vessel in the patient’s chest for the patient to receive stem cells. The use of chemotherapy is to fight against cancer cells.
Myelodysplastic Syndrome DiagnosisAs most symptoms stay hidden for a long time, doctors usually recommend blood tests and bone marrow biopsy. Complete blood count Blood tests are done to check WBC, RBC, and platelets’ appearance, shape, and size. Picture Courtesy: cancer.org Cytogenic analysis A laboratory test is done in which the chromosome of cells present in a bone marrow sample is checked to analyze a broken, damaged, rearranged, or extra chromosome. Bone marrow aspiration and biopsy A small needle is inserted into the hip bone to thoroughly check bone marrow, surrounding blood, and bone evenness in bone marrow biopsy. Picture Courtesy: cancer.gov
What are the most common symptoms associated with Myelodysplastic syndrome?
In the initial stage finding symptoms is a bit challenging and tricky, but later it can show:
- Very fast heartbeat
- Trouble during climbing stairs, cycling, brisk walking, and other exercises
- Sinus infection
- Pale body parts because of less RBC
- Skin infections
- Lung and bladder infection
- Loss of appetite
- Stuffy nose
- Continuous fever
- Nose bleeds
- Mouth sores
- Chest tightness or pain
Actual symptoms develop when counts of Red blood cells, white blood cells, and platelets decrease.
What are the causes of Myelodysplastic syndrome?
When there is some sort of defect in bone marrow or stem cells, people diagnosed with anemia have a very high chance of getting Myelodysplasia.
- Infection and bleeding through thrombocytopenia
- Infection and bleeding due to leukopenia
- If cancer treatment is done frequently, such as radiation therapy and chemotherapy, getting Myelodysplastic syndrome is high.
- If a person is inhaling hazardous chemicals, benzene exposure, pesticides, and lead in an industrial area can cause this disease.
- It can happen in chain smokers.
1. When to commence consultation if a person has Myelodysplasia?
The first consultation should be done with a known or family doctor. The general physician will guide the patient to a hematologist.
2. Are there any restrictions that a Myelodysplasia patient should follow?
Indulge in a healthy and balanced diet, stay away from areas filled with benzene and toluene, quit smoking, and don’t indulge in very intense exercises. Basic exercises also work best.
3. What is the prognosis of Myelodysplastic syndrome?
If a person just has MDS and is also in early-stage treatments, diagnosis and specific medications can save their life and increase the survival rate by 20%. Still, if a person carries MDS and AML (Acute myelogenous leukemia), the survival rate might decrease. However, that still depends on their symptoms. If the patient is in the first stage, they can live almost 5-6 years more if the patient is in the last stage, then hardly 6-10 months.
4. What are the types of Myelodysplastic syndromes?
The Myelodysplastic syndromes are divided into subtypes based on the type of cells involved, such as white blood cells, red blood cells, and platelets.
- Myelodysplastic syndromes with single-lineage dysplasia
- Myelodysplastic syndrome with multi-lineage dysplasia
- Myelodysplastic syndrome with ring sideroblasts
- Myelodysplastic syndromes with isolated del(5q) chromosome abnormality.
- Myelodysplastic syndromes with excess blasts
- Myelodysplastic syndromes, classifiable.
5. What are the chances of MDS in a person whose age is 45?
90% of MDS is present in people above 50, so those below 50 have only 5-10% chances.
6. Can MDS be cured completely?
There is no cure for MDS. The treatment can help slow the progression of the disease.
7. Can a person die from Myelodysplastic Syndrome?
The most common cause of death in MDS patients is bleeding or infection due to low blood cell count.