What Is Myelodysplastic Syndrome?
Myelodysplastic syndromes occur in the bone marrow, the spongy bone material, and the area where blood cells form. Management of myelodysplastic syndromes slows down the progression of the disease, controls symptoms, and reduces the risk of complications.
Standard options include blood transfusions and medications to improve red blood cell production. In some situations, a bone marrow transplant, called a stem cell transplant, is recommended to replace the bone marrow with donor bone marrow, which is healthy.
What Are the Symptoms of Myelodysplastic Syndrome?
Myelodysplastic syndrome patients do not experience initial signs and symptoms. However, myelodysplastic syndromes show the following symptoms.
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Fatigue.
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Shortness of breath.
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Anemia causes pallor or paleness due to a low red blood cell count.
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Thrombocytopenia causes easy bruising or bleeding due to a reduced blood platelet count.
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Petechiae are pinpoint red spots beneath the skin due to bleeding. Petechiae are seen on the leg and abdomen.
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Leukopenia is a persistent infection due to a reduced white blood cell count.
What Are the Causes of Myelodysplastic Syndrome?
Bone marrow produces new, immature blood cells, which mature over time. Myelodysplastic syndromes are seen due to disruption in the maturation process. The blood cells cannot be completely mature. Blood cells do not develop normally; the death of blood cells occurs in the bone marrow or the bloodstream. There is an increased number of immature, defective cells than mature red cells. This causes problems like fatigue, anemia, infection, and bleeding.
Most myelodysplastic syndromes do not have a specific cause. Other causes might be exposure to cancer drugs, radiation therapy, or chemotherapy.
What Are the Types of Myelodysplastic Syndromes?
Myelodysplastic syndromes are divided as follows.
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Myelodysplastic syndromes with single-lineage dysplasia.
One blood cell type includes white blood cells, red blood cells, or platelets low in number and appears abnormal microscopically.
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Myelodysplastic syndromes with multilineage dysplasia present with two or three abnormal blood cells.
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Myelodysplastic syndromes along ring sideroblasts.
Decrease in the number of one or more blood cell types. The red blood cells in the bone marrow have increased iron rings.
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Myelodysplastic syndromes along isolated chromosomal abnormality.
Decreased number of red blood cells along with specific DNA mutations.
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Myelodysplastic syndromes with excess blasts.
The three types of blood cells, red blood cells, white blood cells, or platelets, reduce and are abnormal when viewed under a microscope. Also, immature blood cells are found in the blood and bone marrow.
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Myelodysplastic syndromes - unclassifiable.
There is a decrease in one or more types of mature blood cells, and the cells look abnormal under the microscope. However, the blood cells appear normal occasionally, showing DNA changes associated with myelodysplastic syndromes.
What Are the Risk Factors for Myelodysplastic Syndromes?
Factors that increase the risk of myelodysplastic syndromes are as follows:
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Old Age:
Myelodysplastic syndrome is generally seen in people older than 60 years of age.
People with a previous history of chemotherapy or radiation are at higher risk.
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Exposure To Chemicals:
Chemicals like benzene are said to cause myelodysplastic syndromes.
What Are the Complications Associated With Myelodysplastic Syndrome?
Complications of myelodysplastic syndromes are as follows.
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Anemia is a decrease in the number of red blood cells. This causes lethargy.
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A decrease in the white blood cell increases the risk of infections.
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A lack of platelets in the blood cannot control bleeding and causes excessive bleeding.
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Makes the individual susceptible to cancer.
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Myelodysplastic syndromes can eventually turn into leukemia, cancer of the bone marrow, and blood cells.
How to Diagnose Myelodysplastic Syndrome?
A physical exam, medical history, and tests help determine myelodysplastic syndrome.
The following tests help to determine myelodysplastic syndrome.
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Blood Tests: Blood tests help to analyze the number of red cells, white cells, and platelets. It also helps visualize unusual changes in the blood cells' size, shape, and appearance.
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Bone Marrow Biopsy: A needle can be used to obtain the bone marrow, generally from a spot on the back of the hipbone, followed by removing a piece of bone with its marrow content. Blood samples and bone marrow biopsy is sent to a lab for analysis.
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Specialized Tests: These analyze specific cell characteristics that determine the type of myelodysplastic syndrome prognosis and treatment plan.
How to Treat Myelodysplastic Syndromes?
Management of myelodysplastic syndromes slows the disease process, relieves symptoms, and avoids complications. In addition, certain medications slow down the progression of the disease. If no symptoms are seen, treatment is not needed. However, regular checkups and laboratory tests are required to evaluate disease signs of progress.
Blood Transfusions:
Blood transfusions, including donors' healthy blood cells, replace red blood cells and platelets in patients suffering from myelodysplastic syndromes. In addition, blood transfusions control and reduce symptoms.
Medications.
Following are the medications used for the treatment of myelodysplastic syndromes.
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Medications aim to increase the number of blood cells the body produces. Artificial growth factor medications are synthetic substances naturally found in the bone marrow. Growth factors let the bone marrow have more red blood cells. This reduces the need for frequent blood transfusions. In addition, growth factors promote white blood cell production and reduce infection risk.
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They stimulate blood cells toward maturation. Medications that stimulate the blood cells reduce the frequency of blood transfusions. This is useful in people who show no growth hormone. In addition, these drugs eliminate the risk of leukemia.
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Certain drugs suppress or control the immune system. As a result, these drugs reduce the need for blood cell transfusions.
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Myelodysplastic syndrome, associated with a gene abnormality of isolated del(5q), can be treated with Lenalidomide or Revlimid.
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Infections control with the help of antibacterial or antiviral medications depending on the cause of the disease.
Bone Marrow Transplant:
A bone marrow transplant called stem cell transplant is the treatment option that can completely cure myelodysplastic syndromes. However, such treatments carry a high risk of severe complications and are only used for people who are medically fit to bear them.
A bone marrow transplant necessitates high doses of chemotherapy drugs to clear defective blood cells from the bone marrow. The abnormal bone marrow stem cells are replaced with healthy cells from the donor. Some low-level chemotherapy drugs reduce the risks of bone marrow transplant in the old age group.
Conclusion
Myelodysplastic syndromes are a set of illnesses characterized by poorly produced or malfunctioning blood cells. Myelodysplastic syndromes are caused by an abnormality in the spongy material inside the bones where blood cells are produced (bone marrow). After a correct diagnosis and prognosis evaluation, myelodysplastic syndromes can be treated on an individual basis with risk adaptation.
