Haematology - myelodysplastic syndrome

Question 1

What occurs in myelodysplastic syndrome?

Answer 1

Myeloid bone marrow cells don’t mature correctly

It causes low levels of blood components that originate from this cell line:

• Anaemia
• Neutropenia (low neutrophil count)
• Thrombocytopenia (low platelets)

Question 2

Who more commonly gets myelodysplastic syndrome?

Answer 2

Over 60

Previous chemo or radiotherapy

Question 3

What can it progress to?

Answer 3

There is an increased risk of transformation into AML

Question 4

Presentation of myelodysplastic syndrome

Answer 4

May be asymptomatic and an incidental finding on FBC

Anaemia sx

Neutropenia Sx - frequent/severe infections

Thrombocytopenia Sx - purpura or bleeding

Question 5

Diagnosis of myelodysplastic syndrome

Answer 5

FBC - may have anaemia, neutropenia and thrombocytopaenia

Blasts on blood film

Diagnosis is confirmed by bone marrow aspiration and biopsy

Question 6

Management of myelodysplastic syndrome

Answer 6

Depending on the symptoms, risk of progression and overall prognosis the treatment options are:

• Watchful waiting
• Supportive treatment with blood transfusions if severely anaemic
• Chemotherapy
• Stem cell transplantation