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Myelodysplasia (MDS): Treatment, symptoms, advice and help

About myelodysplasia (MDS)

Myelodysplasia refers to a group of disorders in which the bone marrow does not function normally and produces an insufficient number of healthy blood cells. Myelodysplasia affects the production of any, and occasionally all, types of blood cells, including red blood cells, white blood cells and platelets.

Myelodysplasia (MDS): Incidence, age and sex

Myelodysplasia may affect an individual of any age; however it is more commonly encountered in older adults. Males are slightly more affected than females.

Signs and symptoms of myelodysplasia (MDS): Diagnosis

The signs and symptoms of myelodysplasia are non-specific and generally related to reduced number of healthy blood cells. Decreased red blood cell count causes anaemia which is manifested by tiredness, shortness of breath, fatigue and pale skin. Reduced count of white blood cells results in increased susceptibility to infection. Low platelet count causes increased susceptibility to bleeding and bruising as well as subcutaneous haemorrhages leading to purpura and petechia. Most affected individuals may remain asymptomatic.

Physical examination may reveal an enlarged spleen and liver. Blood test reveals decreased count of blood cells. Bone marrow examination showing dysplastic marrow or chromosomal studies of bone marrow aspirate are useful in establishing diagnosis.

Causes and prevention of myelodysplasia (MDS)

The exact cause of myelodysplasia is not clear. It may be caused due to excessive or persistent exposure to radiation or chemicals like benzene. It may also result from treatment with cancer drugs (chemotherapeutic agents) like procarbazine, nitrosourea and busulphan.

Myelodysplasia (MDS): Complications

About 50% of deaths occur as a result of bleeding and infection. Leukaemia that occurs as a result of myelodysplasia is notoriously resistant to treatment.

Myelodysplasia (MDS): Treatment

The goal of therapy is to control symptoms, improve quality of life, improve overall survival and decrease the progression of Myelodysplasia to leukaemia. Supportive care with blood product support and hematopoeitic growth factor (erythropoietin) is the mainstay of therapy. Drugs used for treatment include 5-azacytidine, Decitabine and Lenalidomide. Stem cell transplantation offers the potential for curative therapy in younger patients (less than 40 years of age) and in severely ill patients.