Description

The myelodysplastic syndromes are a group of disorders caused by blood cells that are improperly formed or are not working correctly. Myelodysplastic syndromes result from something amiss in the spongy material inside bones where blood cells are made (bone marrow).

Management of myelodysplastic syndromes is more often the intention of delaying the disease, relieve symptoms, and prevent complications. The most common measures include blood transfusions and medications to stimulate the production of blood cells. In certain situations, a bone marrow transplant, also known as stem cell transplantation, it may be recommended to replace the bone marrow with healthy bone marrow from a donor.

Symptoms

People with myelodysplastic syndromes may not experience signs and symptoms in the beginning.

At the time, myelodysplastic syndromes, can cause:

  • Fatigue
  • Shortness of breath
  • Unusual paleness (pallor), which occurs due to a low count of red blood cells (anemia)
  • Easy or unusual bleeding or bruising, which occurs due to a low blood platelet count (thrombocytopenia)
  • Identify size red spots under the skin that are caused by bleeding (petechiae)
  • Frequent infections, which occur due to a low white blood cell count (leukopenia)

When to see a doctor

Make an appointment with your doctor if you have signs or symptoms that worry you.

Causes

In a healthy person, the bone marrow produces new, immature blood cells that mature over time. Myelodysplastic syndromes occur when something disrupts this process, so that the blood cells do not mature.

Instead of developing normally, blood cells die in the bone marrow or right after entering the bloodstream. With time, there are more immature, defective cells than healthy ones, causing problems such as fatigue caused by too few red blood cells (anemia), infections caused by very few healthy white blood cells (leukopenia), and the bleeding caused by very few of clotting of blood platelets (thrombocytopenia).

The majority of myelodysplastic syndromes have no known cause. Others are caused by exposure to cancer treatments, such as chemotherapy and radiation, or toxic chemicals, such as benzene.

Types of myelodysplastic syndromes

The World Health Organization divides the myelodysplastic syndromes into subtypes depending on the type of blood cells — red blood cells, white blood cells and platelets — involved.

The myelodysplastic syndrome subtypes include:

  • Myelodysplastic syndromes with a single lineage dysplasia. One of the blood type of white blood cells, red blood cells or platelets — is low in number and seem to be abnormal under the microscope.
  • The myelodysplastic syndrome with multilineage dysplasia. In this subtype, two or three types of abnormal blood cells.
  • Myelodysplastic syndromes with ring sideroblasts. This subtype consists of a low number of one or more types of blood cells. One feature is that the red blood cells in the bone marrow contains rings of excess iron.
  • The myelodysplastic syndrome with isolated del(5q) chromosome abnormality. People with this subtype has a low number of red blood cells, and the cells have a specific mutation in his DNA.
  • Myelodysplastic syndromes with excess blasts. In this subtype, any of the three types of blood cells — red blood cells, white blood cells or platelets — may be low and appear abnormal under a microscope. Very immature blood cells (blasts) are found in the blood and bone marrow.
  • The myelodysplastic syndrome, unclassifiable. In this subtype, there is a reduced number of one or more types of mature blood cells and the cells might look abnormal under the microscope. Sometimes the blood cells appear normal, but the analysis can be found that the cells have changes in the DNA that are associated with myelodysplastic syndromes.

Risk factors

Factors that may increase the risk of myelodysplastic syndromes are:

  • Advanced age. The majority of people with myelodysplastic syndromes are over the age of 60 years.
  • The prior treatment with chemotherapy or radiation therapy. Chemotherapy or radiation therapy, both of which are commonly used to treat cancer, it can increase your risk of myelodysplastic syndromes.
  • Exposure to certain chemicals. Chemicals, including benzene, have been linked to myelodysplastic syndromes.

Complications

Complications of myelodysplastic syndromes are:

  • Anemia. The reduction in the number of red blood cells can cause anemia, which can make you feel tired.
  • The recurrent infections. Having too few white blood cells increases the risk of serious infections.
  • Bleeding that does not stop. Lack of platelets in the blood to stop the bleeding can lead to excessive bleeding.
  • Increased risk of cancer. Some people with myelodysplastic syndromes, eventually, you may develop a cancer of the bone marrow and blood cells (leukemia).

Diagnosis

A physical examination, medical history, and the evidence can be used if your doctor suspects that you have a myelodysplastic syndrome.

Tests may include:

  • Blood tests. Your doctor may order blood tests to determine the number of red blood cells, white blood cells and platelets, and look for unusual changes in the size, shape and appearance of the various cells of the blood.
  • Harvesting of bone marrow for testing. During a bone marrow biopsy and aspiration, a thin needle is used to withdraw (aspirate) a small amount of liquid bone marrow, usually from a spot on the back of the hip bone. Then, a small piece of bone to his bone marrow is removed (biopsy).

The blood and bone marrow samples are sent for laboratory analysis. Specialized tests can determine the specific characteristics of the cells that are going to be useful to determine the type of myelodysplastic syndrome, their prognosis and treatment options.

Treatment

Management of myelodysplastic syndromes is more often the intention of delaying the disease, relieve symptoms, and prevent complications. There is No cure for myelodysplastic syndromes, but some medications can help to slow the progression of the disease.

If you have no symptoms, the treatment may not be needed immediately. In its place, the doctor may recommend regular examinations and laboratory tests to check your state and see if the disease progresses.

Research on myelodysplastic syndromes is in progress. Ask your doctor about clinical trials for which you may be eligible.

Blood transfusions

Transfusions of blood cells in the blood of donors can be used to replace the red blood cells and platelets in people with myelodysplastic syndromes. Blood transfusions can help to control the symptoms.

Drugs

Treatment of myelodysplastic syndromes can include drugs that:

  • To increase the number of blood cells your body makes. Called growth factors, these medicines are man-made versions of the chemicals that are naturally found in the bone marrow. The growth factors that stimulate the bone marrow to produce more red blood cells can help reduce the need for frequent blood transfusions. Growth factors that promote the production of white blood cells can reduce your risk of infection.
  • Stimulate the blood cells to mature. Medications that help to stimulate the blood cells to mature can reduce the need for frequent blood transfusions in people who are not helped by growth factors. Some of these drugs can also reduce the risk of disease can progress to leukemia.
  • Suppress the immune system. Medications that suppress or control of your immune system are used in certain myelodysplastic syndromes reduce the need for transfusions of red blood cells.
  • Help people with certain genetic abnormalities. If your myelodysplastic syndrome is associated with a mutation in the gene called isolated del(5q), your doctor may recommend lenalidomide (Revlimid).
  • The treatment of infections. If your condition causes you to have infection, you're going to receive treatments to control them.

Bone marrow transplantation

A bone marrow transplant, also known as stem cell transplant is the only treatment option that offers the possibility of a cure for myelodysplastic syndromes. But this treatment carries a high risk of serious complications, and is usually reserved for people who are healthy enough to endure it.

During a bone marrow transplant, the high doses of chemotherapy drugs are used to clean the defective blood cells from your bone marrow. Then, the abnormal bone marrow stem cells are replaced with healthy, donated cells (allogeneic).

In some situations, less intense chemotherapy drugs can be used to reduce the risks of a bone marrow transplant for older adults and those who might not otherwise be considered for this treatment.

Lifestyle and home remedies

Because people with certain myelodysplastic syndromes have a low count of white blood cells, that are subject to recurrent, and often serious infections.

To reduce the risk of infections:

  • Wash your hands. Wash your hands often with warm water and soap, especially before eating or preparing food. Carry an alcohol-based hand sanitizer for times when water is not available.
  • Be careful with the food. Thoroughly cook meat and fish. Avoid fruits and vegetables that cannot be peeled, especially the lettuce, wash away all the products you use before peeling out of the same. To increase security, you can avoid all raw foods.
  • Avoid people who are sick. Try to avoid close contact with sick people, including members of the family, and coworkers.

Preparing for your appointment

It is likely to start by seeing your family doctor or primary care physician. If your doctor suspects that you have a myelodysplastic syndrome, you may be referred to a doctor who specializes in blood disorders (hematologist).

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as restrict your diet.

Make a list of:

  • Its symptoms, including those that may seem unrelated to the reason for the appointment, and when they began
  • Key personal information, including previous treatment for the cancer, or exposure to toxic chemicals
  • All the drugs, vitamins, and supplements you are taking, including dose
  • Questions to ask your doctor

Consider the possibility of a family member or a friend to help you remember the information they give you.

For myelodysplastic syndromes, questions to ask your doctor might include:

  • What type of myelodysplastic syndrome have?
  • More evidence is needed?
  • What is my prognosis?
  • What is my risk of leukemia?
  • If I need treatment, what are my options and what do you recommend?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask questions, such as:

  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of the Myelodysplastic syndromes