Myelodysplastic Syndromes, which were previously considered rare, are currently known as some of the most frequently occurring hematological neoplasms, perhaps affecting over 30,000 patients each year within the U.S. The nation's regulatory permission of lenalidomide, azacitidine and decitabine, from 2004 to 2006 appeared to indicate a new age in the improvement of therapy for disease modification for these disorders. However, no indications of drugs being approved for MDS appear to be present in the U.S. for the past 8 years. There are no curative drugs available so far. However, some compounds under development may be approved soon. Consequently, diagnoses of MDS are still quite a heavy load, both on patients and medical care systems (Bejar & Steensma, 2014).Background
Myelodysplastic Syndromes are a set of distinct disorders of the bone marrow that prevent the victim's bone marrow from producing sufficient fit blood cells. The disorders are often called "failure of the bone marrow." MDS is mainly a disorder for elderly people (most of the victims are more than 65 years old). However, even younger people can have the disease. In order to have a better understanding of MDS, one needs to first look at some basics facts about blood and bone marrow. The human bone marrow acts as a manufacturer of three blood cell types: the white and red cells, and the platelets. Good bone marrow creates undeveloped blood cells known as progenitor cells, blasts, or stem cells that typically grow into mature, completely functional white cells, platelets, and red cells. In MDS, the stem cells could fail to grow, and they may accumulate within the patient's bone marrow. Alternatively, the stem cells' life span may be shortened, leading to abnormally few developed blood cells circulating (MDS Foundation, 2014-2017).
Besa, Nagalla and Krishnan (2016) state that MDS could involve a single, two or even three (all) of the cell lineages of myeloid hematopoiesis; which are megakaryocytic, erythrocytic or granulocytic. This is determined by the stage and subtype of the disorder. The heterogenous nature of MDS shows that the course of the illness involves a sequence of cytogenetic occurrences. In a small cluster of MDS patients, acquiring more genetic abnormalities leads to the conversion of the disease into AML (acute myelogenous leukemia). Therefore, even though MDS is clonal, it is also classified as premalignant.
Many patients wonder if MDS can be classified as a kind of cancer. The disease is indeed cancer. Cancer is caused by a change/mutation to an ordinary cell that leads to growth of abnormally functioning cells. Nonetheless, the impact of an illness on the quality of life of a patient matters much more than the word that describes that illness. MDS can develop slowly and cause less interference with the life of a patient, than other illnesses, not...
Symptoms and signs could be caused by either the disorder or other health problems. A regular blood test could show a reduction in the number of red cells, or low levels of hematocrit, at times also a reduction in the number of platelets or white cells. In some cases, one may have less than normal number of platelets and white cells and normal level hematocrit. Nonetheless, some patients, especially those who have fewer than usual blood cells, have definite symptoms. Therefore, symptoms differ by the type of blood cell involved and the blood cell count level.
Low Red Cell Count (ANEMIA)
Most patients are usually suffering from anemia when it is first discovered that they have MDS. Anemic patients have a consistently low level of hematocrit (the amount of red cells in the body) or consistently low hemoglobin levels (the protein in blood in charge of transporting oxygen to tissues in the body). People suffering from anemia, in general, experience fatigue. They are constantly tired and weak. The severity of anemia varies with patients. In mild cases, the victims may be well or maybe a little fatigued. For patients with moderate anemia, there may be fatigue, palpitations of the heart, pale skin and difficulty in breathing. In severe cases, most of the patients look pale and suffer chronic overpowering fatigue as well as difficulty in breathing. Since severe anemia leads to a reduction in the flow of blood to the heart and older victims have a higher probability of having cardiovascular symptoms, such as chest pain. Even though chronic anemia has a low mortality rate, it can lead to drastic reduction of the victim's quality of living (MDS Foundation, 2014-2017).
Low White Cell Count (NEUTROPENIA)
A reduction in the number of white cells leads to a reduction in the ability of the body to fight bacterial infection. Neutropenic patients are likely to be vulnerable to infections of the skin, sinus infections (with such symptoms as nasal congestion), infections of the lungs (with such symptoms as difficulty in breathing and cough), or infections of the urinary tract (with symptoms such as frequent and painful urination). These infections may cause fever (MDS Foundation, 2014-2017).
Low Platelet Count (THROMBOCYTOPENIA)
Thrombocytopenic patients have a high tendency of getting bruises and bleeding even due to minor scrapes and bumps. It is common for them to nosebleed and have bleeding gums; especially after handling their teeth. Before any dental work, it is important to talk to your hematologist. They may recommend prophylactic antibiotic consumption, which is recommended as bleeding and infection may be a danger to most people…
