Q: My husband has recently been diagnosed with myelodysplastic
syndrome. Can you tell me what this is? I have been told that it is
similar to aplastic anemia. He is 72.
A: Myelodysplastic syndrome and aplastic anemia are similar diseases
where the bone marrow, which is the blood manufacturing centre, does
not make enough red or white blood cells or platelets. In aplastic
anemia, the bone marrow is almost empty of blood-making cells, while in
myelodysplastic syndrome or MDS, there is actually an excessive amount
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of cells, but they are immature and not good at their job. The immature
cells take up room and crowd out the normal cells.
MDS is more frequent in the elderly, but it can occur in children. MDS
can sometimes lead to acute leukemia. Both diseases are rare.
MDS and aplastic anemia can occur as the result of exposure to
radiation, certain drugs and chemicals or even pesticides and
insecticides. There is also a possibility that some forms of the
disease are inherited by a recessive gene. One such type is sometimes
known as Fanconi’s anemia, which is more likely to develop into acute
myeloid leukemia.
Symptoms of these rare blood disorders are weakness, exhaustion,
excessive sleeping, palpitations and headaches.
Low white blood cell counts lead to an increased susceptibility to
infections, fevers and mouth ulcers, while low platelet levels cause
spontaneous bruising, nosebleeds and bleeding gums.
Fewer red blood cells mean the blood carries less oxygen, which is what
leads to the exhaustion, breathlessness and general weakness. Prolonged
severe anemia will eventually lead to heart failure and death if not
treated.
Treatment for acquired aplastic anemia involves immunosuppressant drugs
such as ATG plus Cyclosporine. Stem cell transplants of the bone marrow
can be done in patients under age 30. These are an effective cure in 80
percent of patients.
Myelodysplastic syndrome is usually treated with regular blood
transfusions every two or three weeks and by giving a growth factor to
stimulate blood production.
Chemotherapy is another alternative, especially if MDS turns into
leukemia.
For more information, visit the international association website at
www.aplastic.org. The Canadian association for aplastic anemia and
myelodysplastic syndrome is situated at www.aplastic.
ualberta.org. Fanconi Canada has a website at www.
fanconicanada.org. You can also write to the Canadian association at
22 Aikenhead Road, Etobikoke, Ont., M9R 2Z3, or phone 888-840-0039 toll
free.
Clare Rowson is a medical doctor with a practice near Belleville, Ont.
Her columns are intended for general information only. Individuals are
encouraged to also seek the advice of their own doctor regarding
medical questions and treatments.
