Primary care for you and your family, close to home.
Wellstar Health System provides superior care for myelodysplastic syndromes, offering a comprehensive spectrum of top-notch physicians, treatment options and diagnostic tools. In addition Wellstar offers such innovative advances in the fight against myelodysplastic syndrome, including:
Myelodysplastic syndromes (MDS) are a group of disorders caused by poorly formed blood cells. It originates in the bone marrow, where blood cells production has become disordered and ineffective.
Normally, bone marrow produces blood stem cells that eventually develop into mature blood cells. When a blood stem cell divides, it makes two cells—a stem cell, and either a lymphoid stem cell, which develops into a lymphocyte, a type of white blood cell; or a myeloid stem cell, which can develop into either:
In myelodysplastic syndromes, the stem cells do not mature properly into healthy, useful blood cells; dysplasia refers to abnormal development. The immature cells, called blasts, do not function normally, and die in the marrow or shortly after they enter the blood stream. This leaves a shortage of normal blood cells, causing a range of health problems.
In about a third of cases, MDS develops into a fast-growing cancer of bone marrow cells called acute myeloid leukemia. In the past, MDS was called pre-leukemia or smoldering leukemia; however, since most MDS patients do not get leukemia, MDS is regarded to be a separate form of cancer.
MDS are classified by abnormalities in the marrow and blood cells:
Myelodysplastic syndromes are also classified by apparent cause:
Symptoms of myelodysplastic syndromes mimic those of many other illnesses, making the disease hard to diagnose. Sometimes, there are no symptoms, and the disease is discovered through a routine complete blood count (CBC).
Symptoms of MDS include:
Most people who are exposed to benzene, radiation treatment, or chemotherapy do not develop MDS; those who do may have inherited an inability to detoxify the causative agent.
Wellstar supports scientific research that shows certain lifestyle choices can lower a person’s risk of some cancers. The single most important behavior to avoid is smoking, which is implicated in up to 30 different kinds of cancer. Cigarette smoke contains benzene, which has been implicated in some cases of MDS. Wellstar supports smoking cessation programs and will endeavor to help patients who want to stop smoking through a variety of cessation efforts. Different approaches work for different people, and Wellstar experts can help tailor a cessation program that will enhance your efforts of successfully quitting.
Still, in the vast majority of cases of myelodysplastic syndromes, most patients had no known risk factors.
Screening tests, like mammograms for breast cancer, are used to detect illness in a general population, including people who have no symptoms.
There are no screening tests for myelodysplastic syndromes. Some cases are discovered during blood tests; these tests are sometimes prescribed for people at elevated risk of MDS, like those who have undergone chemotherapy.
If you have any MDS symptoms, or MDS is suspected based on the results of a blood test, your Wellstar physician will take a complete medical history and conduct a physical examination.
A complete blood count will be run on a sample of your blood. This reveals:
A peripheral blood smear may be performed. In this test, a sample of blood is examined to look for changes in the number, type, shape and size of blood cells and for too much iron in red blood cells.
In a cytogenetic analysis, a sample of blood or bone marrow is examined under a microscope to look for certain chromosomal changes that are associated with MDS.
A small piece of bone, blood, and marrow are extracted in in a bone marrow aspiration and biopsy. This tissue is examined under a microscope by a pathologist for abnormal cells.
While MDS is not staged in the same manner as other cancers, the International Prognostic Scoring System (IPSS) provides a measure of the aggressiveness of MDS. IPSS uses three indicators to predict the course of the disease:
Once myelodysplastic syndrome has been detected and classified, your team of specialists in hematology, oncology, radiation oncology, and pathology will work together to assess the best course of treatment for your type of MDS. This may include chemotherapy, targeted drugs, or a stem cell transplant; there is no surgical treatment for MDS.
For patients at low risk, with sufficient blood counts and not needing transfusions, watchful waiting is generally recommended. These patients may be able to maintain their normal activities, but their health and blood counts will be monitored closely.
Some MDS patients need ongoing blood transfusions to relieve MDS symptoms.
Patients who have symptoms of low red blood cell count like fatigue and shortness of breath receive red blood cell transfusions. They are monitored for “iron overload”, which can damage the heart and liver; there are medications that remove excess iron if necessary.
To alleviate symptoms like unusual bleeding or bruising, or to prepare for a procedure that may cause bleeding, platelet transfusions are provided.
Drugs used to increase the number of healthy blood cells your body produces include:
MDS chemotherapy uses drugs to destroy abnormal blood cells or stop them from dividing.
Chemotherapy may be an option for high-risk patients who are in good overall health but do not have a suitable donor for a blood or marrow transplant (see below); it is also sometimes used to bring MDS into remission before a patient receives a transplant. However, the intense form of chemotherapy used for MDS (induction chemotherapy) may not be suitable for some older, less healthy patients.
About half of patients treated with induction chemotherapy reach a remission, but relapse is common and the rate of long-term survival is low, particularly in older patients.
Blood stem cells are harvested from the blood or bone marrow of a compatible donor, and frozen. After your defective stem cells are destroyed with intense chemotherapy, they are replaced with the donated cells.
Unfortunately, the risk of transplant-related complications is high, especially in the older people whom MDS tends to strike. However, high-risk MDS patients who are under age 55 who undergo stem-cell transplantation enjoy a 40-50% long-term remission rate.
You’ll be referred after your recovery from myelodysplastic syndromes to Wellstar’s medical oncology team for treatment, surveillance and survivorship programs. These comprehensive programs focus on diet, exercise and nutrition to help you reduce the risk of recurrence. In addition, because of the location of head and neck cancers and potential damage to the neck, mouth, nose and other areas of the face, rehabilitation specialists at Wellstar will help maximize your chances of returning to as normal a life as possible.
Cancer care at Wellstar is more than advanced technology, clinical research, and highly specialized physicians and nurses. It includes an array of supportive care services to improve the patient experience before, during and after treatment. All of these services are available within the Wellstar system, including:
Wellstar’s certified palliative care physicians and certified registered nurses are dedicated to providing compassionate, quality care in various settings, including home hospice, inpatient hospice nursing homes, assisted living facilities and nursing homes. Wellstar offers caring and compassionate hospice care for patients and their families in one of Georgia’s oldest hospice programs serving Bartow, Cherokee, Cobb, Douglas and Paulding counties.