Myelodysplastic Syndrome

Myelodysplastic Syndrome

Myelodysplastic syndromes are a group of diseases caused by damage to blood cells. This condition occurs when the blood cells produced by the bone marrow do not form properly.

In the body, the bone marrow is responsible for producing red blood  cells, white blood cells , and platelets. These blood cells function to carry oxygen throughout the body, fight infection, and help the blood clotting process.

In people with myelodysplastic syndromes, the bone marrow produces abnormal blood cells. These abnormal cells do not develop fully and will die while still in the bone marrow or when they enter the bloodstream.

Over time, the number of abnormal blood cells will increase and exceed the number of healthy or "mature" blood cells. This then causes the symptoms of myelodysplastic syndrome.

Myelodysplastic syndrome belongs to a  type of blood cancer . This syndrome most often affects people over the age of 60.

Types of Myelodysplastic Syndromes

Myelodysplastic syndrome is divided into several types, namely:

  • Myelodysplastic syndrome with unilineage dysplasia , which is when one type of blood cell (red blood cells, white blood cells, or platelet cells) is low in number and looks abnormal under a microscope
  • Myelodysplastic syndrome with multilineage dysplasia , which is when two or three types of blood cells appear abnormal
  • Myelodysplastic syndrome with ring sideroblasts , which is when more than one type of blood cell is low in number with the characteristics of red blood cells that have an iron ring ( ring sideroblasts )
  • Myelodysplastic syndrome associated with isolated del chromosome abnormality , which is when red blood cells are few in number and accompanied by mutations in the DNA in these cells
  • Myelodysplastic syndrome with excess blasts  (types 1 and 2), which is when one type of blood cell is small in number and looks abnormal, accompanied by the presence of blood cells that are not "mature" in the blood and bone marrow
  • Myelodysplastic syndrome, unclassifiable , which is when one type of "mature" blood cell is low in number, accompanied by abnormal-looking white blood cells and platelet cells

Myelodysplastic Syndrome Causes

Myelodysplastic syndromes occur when the DNA in stem cells ( stem cells ) in the bone marrow is damaged. As a result, the bone marrow is unable to produce healthy blood cells.

It is not yet known what causes this condition, but there are a number of factors that can increase a person's risk of developing myelodysplastic syndrome, namely:

  • Over 60 years old
  • Have had  chemotherapy or radiotherapy
  • Exposure to chemicals, such as cigarette smoke, pesticides, and benzene
  • Exposure to heavy metals, such as lead and mercury

Myelodysplastic syndrome is also a complication of  Kostmann's syndrome .

Myelodysplastic Syndrome Symptoms

In its early stages, myelodysplastic syndromes rarely present with signs or symptoms. However, as the disease progresses, sufferers may experience symptoms such as:

  • Dizzy
  • Hard to breathe
  • The body gets tired easily
  • Red spots appear under the skin due to bleeding
  • Pale, due to a lack of red blood cells ( anemia )
  • Recurrent infections, due to a lack of white blood cells
  • Easy bruising or bleeding, due to low platelet count

In addition, people with myelodysplastic syndromes can also experience several other symptoms, such as fever, loss of appetite, decreased body weight, and bone pain.

When to see a doctor

Check with your doctor if you experience the above symptoms, especially if you have factors that can increase your risk of developing myelodysplastic syndromes. If treated quickly, you can avoid serious complications from this disease.

Myelodysplastic Syndrome Diagnosis

The doctor will ask about the patient's symptoms and medical history, followed by a physical examination. Next, the doctor will carry out the following examinations to confirm the diagnosis:

  • Complete blood test A complete
    blood test is done to determine the number of red blood cells, white blood cells, and platelets. Blood tests also aim to check whether there are changes in the size and shape of blood cells.
  • Bone marrow aspiration Aspiration of a
    sample of bone marrow fluid (bone marrow aspiration) followed by taking a sample of bone marrow tissue (biopsy) aims to determine the condition of the blood cells as a whole.
  • Genetic tests Genetic
    tests are performed using a sample of bone marrow tissue. This examination aims to see the possibility of genetic changes or abnormalities, including the chromosomes.

Myelodysplastic Syndrome Treatment

Treatment of myelodysplastic syndromes aims to inhibit disease progression, relieve symptoms, and prevent bleeding and infection. Some methods that doctors can do are:

Blood transfusion

Blood transfusion  aims to replace damaged blood cells with healthy blood cells. Blood transfusions can be accompanied by chelation therapy ( chelation therapy ), to reduce iron levels in the blood due to too frequent blood transfusions.

Drugs

The drugs given aim to  increase the production of blood cells , treat infections, suppress the immune system, or stimulate the maturation of blood cells. These drugs include:

  • Epoetin
  • Darbepoetin alfa
  • Filgrastim
  • Antibiotics
  • Lenalidomide
  • Azacytidine
  • Decitabine

Bone marrow transplant

Bone marrow transplant or stem cell transplant aims to replace the patient's bone marrow with healthy bone marrow from a donor. This therapy is preceded by administration  of high doses of chemotherapy drugs  to destroy damaged stem cells.

Complications of Myelodysplastic Syndromes

Complications that may occur due to myelodysplastic syndromes include:

  • Anemia due to lack of red blood cells
  • Acute myeloblastic leukemia
  • Bleeding that is difficult to stop due to low levels of platelets ( thrombocytopenia )
  • Frequent infections due to low white blood cell count

Myelodysplastic Syndrome Prevention

It is not known exactly how to prevent myelodysplastic syndromes. However, you are advised to stop smoking and avoid exposure to chemicals that can increase the risk of this condition.

If you have myelodysplastic syndrome, you can get frequent infections due to a low number of healthy white blood cells. To prevent this, do the following efforts:

  • Wash hands with water and soap or  hand sanitizer before preparing food and before eating.
  • Wash and peel vegetables or fruits before processing and consuming them.
  • Cook food ingredients until cooked before consuming them.
  • Avoid direct contact with people who are sick.
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