Can 5q- syndrome progress to acute myeloid leukemia?

Question

Hello doctor,

My mother has been diagnosed with MDS (5q- syndrome) and receives ARANESP injections every three weeks. Her hemoglobin levels have been in the range of 9.3 to 11.4 over the past six months. Due to dementia, she primarily focuses on her immediate comfort and daily routine. Hospital visits are distressing for her, and I am contemplating discontinuing treatment.

Could you outline any other potential long-term health effects besides fatigue and easy bruising as her hemoglobin decreases? Given her age of 92 and the lower likelihood of 5q- syndrome progressing to acute myeloid leukemia, should I be concerned about that possibility? Despite her long-standing struggles with depression and anxiety, my mother is physically healthy and does not require a walker or cane.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your mother has been diagnosed with MDS (myelodysplastic syndrome) with deletion 5q, and it is reassuring to know that the prognosis generally appears favorable with a mild clinical course. The doctor has prescribed a synthetic erythropoietin to stimulate red blood cell production, which helps maintain her hemoglobin levels. The bruising your mother is experiencing is likely attributed to senile purpura, a common skin condition associated with aging.

Additionally, dementia can develop with advancing age, particularly with a history of depression. In the case of MDS with deletion 5q, I suggest considering Lenalidomide if necessary. Please consult your doctor and take the medicines. Lenalidomide can reduce the need for transfusions and even reverse cytogenetic abnormalities. However, the decision should be made after a thorough examination, considering all aspects of your mother's health.

Please ensure your mother receives proper care, and I advise consulting a nearby hematologist for a comprehensive evaluation and a thorough discussion of her case. Her prognosis is reassuring, and the likelihood of developing leukemia appears to be very low. Nevertheless, it is essential not to discontinue treatment without consulting her healthcare provider.

I hope this helps.

Please revert in case of further queries.