MYELODYSPLASTIC DISEASES

Myelodysplastic Diseases -  General Information

Myelodysplastic Diseases also known as Myelodysplastic syndromes are a group of diseases in which the bone marrow does not produce enough healthy blood cells. These are diseases of the bone marrow and also of the blood. Usually the bone marrow produces stem cells- that are immature cells- which develop into three types of blood cells:

• Red blood cells- are the ones which carry the oxygen and nutriments to all the tissues of the body.
• White blood cells- are the cells which fight against infections and diseases.
• Platelets – are the cells which prevent bleeding by making blood clots.

In the case of Myelodysplastic syndromes, the stem cells do not mature in healthy red and white blood cells, and in platelets. The immature blood cells are called blasts, and they do not function at the normal parameters nor do they die in the bone marrow. Because they are not destroyed there is less space for the normal blood cells to develop. When there are fewer blood cells anemia, infection or bleeding can occur. Blood cells are produced in the bone marrow that is the spongy tissue inside a part of the bones. During childhood our bones produce blood cells, but as we get older the blood cells are produced in shoulders, pelvis and vertebrae. Blood cells are at first stem cells, and about 5% of them remain immature and are kept in reserve until out body needs them, the rest are maturing through a series of stages; during these stages they are called blast cells until they reach maturity and transform in specialized blood cells.

Myelodysplastic Diseases – Symptoms

There are several types of Myelodysplastic Diseases, such as:

• Refractory anemia.
• Refractory anemia with ringed sideroblasts.
• Refractory anemia with excess blasts.
• Refractory anemia with excess blasts in transformation.
• Refractory cytopenia with multilineage dysplasia.
• Myelodysplastic syndrome associated with an isolated del (5q) chromosome abnormality.
• Unclassifiable myelodysplastic syndrome

It is well known that any medical disorder (including Myelodysplastic Diseases) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from one of these disorders (Myelodysplastic Diseases) or from any other medical disorder.

This group of diseases (Myelodysplastic Diseases) does not cause problems in its early stage, but as the bone marrow produces a limited number of healthy blood cells, symptoms and signs are probably to appear. Among them we can mention:

• Fatigue
• Shortness of breath
• Unusual paleness (pallor) due to anemia
• Easy or unusual bruising or bleeding
• Pinpoint-sized red spots just beneath your skin caused by bleeding
• Unintentional weight loss
• Frequent infections especially those in the lungs, throat, sinuses, and skin, mouth, ear infections or periodontal disease
• General weakness
• Loss of appetite
• Rash from thrombocytopenia (which is a shortage of the blood platelets)
• Lightheadedness
• Headache
• Enlarged spleen

Myelodysplastic Diseases – Treatment

There are different treatments for persons with Myelodysplastic Diseases that depend on the following factors:

• Whether the myelodysplastic syndrome occurred after chemotherapy or radiation therapy for another disease.
• Whether the myelodysplastic syndrome has progressed after being treated.
• The age and general health of the patient.

The usual goal for the treatments in this case is the amelioration of the symptoms, their prevention and the prevention of the complications that may appear. At the time there is no treatment that can cure Myelodysplastic Diseases, not even stop it from developing in acute leukemia. Only if the disease is severe or if it gets worse the patient may be advised by his doctor to undergo chemotherapy in order to kill the blast cells.  Chemotherapy is based on drugs that kill the blast cells or stop them from dividing. There are two types of chemotherapy that are given depending on the stage of the disease and on its type:

• Systematic chemotherapy – when the drug is taken by mouth or injected. This way the drugs reach the cancer cells throughout the body.
• Regional chemotherapy – when chemotherapy is placed directly on a part of the body and it affects only the cancer cells in that specific area.

Another way of treatment is the transfusion therapy that consists in the blood transfusion- red blood cells, white blood cells and platelets are introduced into the body to replace the blood cells that have been destroyed by the treatment or even by the disease. The bad part is that patients who receive frequent blood transfusion have their internal tissues damaged because of the build up of the extra iron. But there is an iron chelation therapy that is a therapy that uses drugs that attach to the iron and are eliminated from the body in the urine. Some of the drugs therapies used in treating Myelodysplastic Diseases in a treatment based on erythropoietin that is administrated to patients, in order to increase the number of the red blood cells and relieve the symptoms of the anemia, such as: Azacitidine (also known as Vidaza) and Decitbaine (also known as Dacogen) which are called differentiation agents and they stimulate the blast cells to develop in normal blood cells. They also delay the development of the disease, but they are not effective to all patients. Another drug is Lenalidomide (also called Revlimid) is diminishes the need of blood transfusions in patients who have an isolated Del (5q) chromosome abnormality. 
The stem cell transplant is another possibility of treating Myelodysplastic Diseases. The transplant consists in replacing the abnormal stem cells with healthy donated cells (allogeneic transplant), usually from the relatives or siblings. This kind of treatment is considered to be one of the therapies that can prolong life. As the risk of the transplant in older people is much higher few people candidate for this procedure. Even in the young people, the number of transplants that are related to death is high, that is why many adults are afraid of this possibility that may also save their lives.