Myelodysplasia

Question 1

What is myelodysplasia?

Answer 1

Myleodysplasia is a group of bone marrow disorders characterised by ineffective haematopoiesis, leading to cytopaenias and dysplastic changes in blood cells. Primarily a disease of the elderly affecting 70-75 year olds.

Question 2

When should it be suspected?

Answer 2

A persistent anaemia with normocytic or macrocytic cells, recurrent infections, and signs of bleeding may indicate myelodysplastic syndrome, especially in the elderly, more common in males

Question 3

What are the blood film findings for myelodysplasia?

Answer 3

nucleated RBCs, Howell-Jolly bodies
large agranular platelets and megakaryocytes
ringed sideroblasts, and basophilic stippling

Question 4

What is a complication with myelodysplasia?

Answer 4

Transformation to AML
Severe infection due to neutropenia

Question 5

What are the risk factors for myelodysplasia?

Answer 5

Older age
Previous cancer and radiation therapy
Environmental exposure to toxins like benzene

Question 6

How does myelodysplasia appear on blood film?

Answer 6

Ringed sideroblasts
Nucleated RBCs
Howell-Jolly bodies: contains remnant of nuclear DNA in RBCs
Large agruanlar platelets and megakaryocytes

Question 7

How is myelodysplasia managed?

Answer 7

Blood trans signs with EPO stimulating agents
Haematopoietic stem cell transplant
Hypomethylating agents to slow progression to AML like lenalidomide

Question 8

Which medication is given as an alternative for haematopoietic stem cell transplant?

Answer 8

Azacitidine, a hypomethylatng agent