Medicine.Myelodysplastic syn.(dr.sabir)

949 views

Published on

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
949
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
38
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Medicine.Myelodysplastic syn.(dr.sabir)

  1. 1. <ul><li>Overview of Myelodysplastic Syndromes (MDS) </li></ul>
  2. 2. The Myelodysplastic Syndromes Overview <ul><li>Clonal disorder characterized by normo to hypercellular marrows, peripheral cytopenias, and cell functional abnormalities </li></ul><ul><li>Dominant feature: Ineffective hematopoiesis with peripheral blood cytopenias </li></ul><ul><li>Bone marrow failure </li></ul><ul><ul><li>Majority succumb to infection or bleeding </li></ul></ul><ul><ul><li>Approximately 30% of patients transform to acute leukemia </li></ul></ul><ul><li>High mortality rate </li></ul><ul><li>Supportive Care has been the standard treatment </li></ul>
  3. 3. The Myelodysplastic Syndromes Epidemiology <ul><li>15,000 - 20,000 new cases/year in US (Adults) </li></ul><ul><li>More common than AML </li></ul><ul><li>Median Survival 0.5 - 4.1 years, depending upon FAB subtype </li></ul><ul><li>Predominantly a disease of the elderly </li></ul><ul><ul><li>Median age > 70 </li></ul></ul><ul><ul><li>Greater incidence in males than females </li></ul></ul><ul><ul><li>Incidence increases with age </li></ul></ul>
  4. 4. The Myelodysplastic Syndromes Diagnosis and Evaluation <ul><li>No specific clinical feature that distinguishes MDS from other causes of pancytopenia </li></ul><ul><li>Lab evaluation often prompted by signs or symptoms </li></ul><ul><ul><li>Fatigue (anemia) </li></ul></ul><ul><ul><li>Infections (neutropenia) </li></ul></ul><ul><ul><li>Bleeding (thrombocytopenia) </li></ul></ul>
  5. 5. The Myelodysplastic Syndromes Diagnosis and Evaluation <ul><li>Laboratory Data </li></ul><ul><li>Anemia, most common early finding </li></ul><ul><li>Neutropenia and thrombocytopenia </li></ul><ul><li>Peripheral blasts +/- depending on subtype </li></ul><ul><li>May have a monocytosis (CMMoL) </li></ul>
  6. 6. The Myelodysplastic Syndromes Diagnosis and Evaluation <ul><li>Bone Marrow Findings </li></ul><ul><li>Usually hypercellular, although can be hypocellular </li></ul><ul><ul><li>Degree of cellularity may interfere with diagnosis </li></ul></ul><ul><li>Dysplasia </li></ul><ul><li>Ringed sideroblasts (RARS) </li></ul><ul><li>Excess blasts (> 5%) (RAEB, RAEB-T, CMMoL) </li></ul>
  7. 7. The Myelodysplastic Syndromes Diagnosis and Evaluation <ul><li>Cytogenetics </li></ul><ul><li>Cytogenetics should be obtained with bone marrow sample </li></ul><ul><li>Karyotype associated with prognosis </li></ul>
  8. 8. The Myelodysplastic Syndromes Classification-FAB <ul><li>Classification BM Blasts Comments </li></ul><ul><li>RA <5% < 15% ringed sideroblasts </li></ul><ul><li>RARS <5% > 15% ringed sideroblasts </li></ul><ul><li>RAEB 5 - 20% </li></ul><ul><li>RAEB-T 21 - 30% auer rods </li></ul><ul><li>CMMoL 1 - 20% monocytes </li></ul>
  9. 9. The Myelodysplastic Syndrome Treatments <ul><li>Best Supportive Care </li></ul><ul><ul><li>Transfusions (RBCs, platelets) </li></ul></ul><ul><ul><li>Antibiotics </li></ul></ul><ul><ul><li>Growth Factors </li></ul></ul><ul><ul><ul><li>EPO +/- G-CSF (or GM-CSF) </li></ul></ul></ul><ul><li>Bone Marrow Transplant </li></ul><ul><li>Chemotherapy and other Novel Agents </li></ul>

×