Myelodysplastic Syndrome - Medical Malpractice Lawyers

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Myelodysplastic Syndrome - Medical Malpractice

Myelodysplastic syndromes used to be called "preleukemia". These are blood conditions that involve the inability to make or produce the myeloid class of blood cells. The most common symptom is anemia and blood transfusions are not out of the question. The bone marrow, if left untreated, progresses to bone marrow failure. About a third of all patients with a myelodysplastic syndrome go on to get acute myelogenous leukemia within a few months or years of having the disease diagnosed. Myelodysplasia means that there is a problem with the stem cells that overproduce some cells and under produce other types of blood cells.

There are five categories of myelodysplastic syndromes:

• Refractory anaemia. This involves less than 5 percent primitive myeloblasts in the bone marrow with red cell precursors primarily affected.
• Refractory anaemia with ringed sideroblasts. This also involves less than 5 percent myeloblasts in the bone marrow but 15 percent or more of red cell precursors have too much iron in them and are called "ringed sideroblasts".
• Refractory anaemia with excess blasts. There are 5-20 percent myeloblasts in the bone marrow.
• Refractory anaemia with excess blasts in transformations. There are 21-30 percent myeloblasts in the bone marrow, just shy of the 30 percent myeloblasts seen in acute myeloid leukemia.
• Chronic myelomonocytic leukemia. Fewer than 20 percent myeloblasts in the marrow and more monocytes than normal in the peripheral blood.

The symptoms of myelodysplastic conditions include being really tired, short of breath, being pale from anemia, bruising or bleeding easily, petechiae beneath the skin (from a low platelet count) and having frequent infections due to a poor immune system. The blood cells that are produced by the bone marrow are immature and do not function properly. This can include red blood cells, white blood cells and platelets. The cells often die within the bone marrow or soon after leaving the bone marrow so that you don't have healthy cells in your blood.

There are two basic types of myelodysplastic syndromes: those with no known cause and those with a reason behind it. Reasons for having myelodysplastic syndrome include radiation exposure, such as after having treatment for cancer, chemical exposure, such as heavy metal toxicity, exposure to smoking, being of an older age, having an isolated deletion at chromosome 5q (a genetic cause), being of a male gender and having had chemotherapy for cancer in the recent past. Exposure to benzene or other industrial chemicals can contribute to having myelodysplastic syndromes.

The diagnosis of myelodysplastic syndromes begins with a blood test that can tell if there are immature cells in the bloodstream or if there are not enough red blood cells, white blood cells or platelets. If the blood test is suspicious, a test of the bone marrow can be done, called a bone marrow biopsy. This will give you a definitive diagnosis of myelodysplastic syndrome.

There is no specific treatment for myelodysplastic syndrome. The treatment is usually supportive with transfusions of red blood cells to relieve anaemia and platelet transfusions in cases of active bleeding or in cases of surgery. You can take erythropoietin or darbepoietin, which are medications that build up the amount of red blood cells the body makes. White blood cells may also need to be given in cases of active infection. There are also medications that stimulate the blood cells to become mature, rather than to remain immature in the bone marrow. Vidaza is one of those medications as is Dacogen. These medications can also delay the progression of the disease into acute myelogenous leukemia. Those with a deletion of 5q respond to Revlimid, a medication that can reduce the need to have a blood transfusion for anaemia.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here