Myelodysplagia

Question 1

What is myelodysplastic syndrome?

Answer 1

Hypoproliferative anemia
• Bone marrow (BM) failure
• Characterized by cytopenias due to BM failure
• Risk of AML development

Question 2

Causes of myelodysplatic syndrome

Answer 2

• Clonal neoplasms from hematopoietic stem cells mutations
• Mutation cause is unknown
• Associated cytotoxic chemotherapy or ionizing radiation exposure
• Environmental toxins
• Inherited genetic abnormalities are rare
• Familial with germline mutation

Question 3

What autoimmune disorders are associated with myelodysplastic syndrome

Answer 3

• Chronic rheumatic heart disease, RA, PA, psoriasis , polymyalgia

Question 4

Who commonly gets myelodysplastic syndrome

Answer 4

• Elderly >70 years
• Slight male for dominance.
• Relatively common form of bone marrow failure
• Secondary or therapy related MDS not age related

Question 5

Symptoms of myelodysplastic syndrome

Answer 5

• Fatigue
• Infections
• Bruising
• Fatigue
• Weakness
• Exercise intolerance
• Angina
• Dizziness
• Cognitive impairment

Question 6

Lab findings of myelodysplastic syndrome

Answer 6

• Thrombocytopenia
• Isolated thrombocytopenia not common
• Peripheral blood smear
• Dysplasia in RBC & WBC
• Platelet abnormalities

Question 7

Myelodysplastic syndrome diagnostic

Answer 7

Bone marrow biopsy

Question 8

Goals of care for myelodysplastic syndrome

Answer 8

• Lessen symptoms
• Improve quality of life
• Prolong survival
• Minimize treatment-related toxicit

Question 9

Treatment options for myelodysplastic syndrome

Answer 9

Allogeneic hematopoietic cell transplantation (HCT)
• Highest potential for cure MDS
• Small subset qualify
• Epigenetic modulators
• Ex. Azacitidine 75-100 mg/m^2/dose SQ daily x7
days for 4 wks
• Adverse reaction w/ BM failure
• Immunosuppressive agents
• Ex. Cyclosporin or alemtuzumab
• Sustain independence from transfusion
• Improved survival
• <60 years of age

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