What You Need to Know About MDS and Anemia
“Myelodysplastic syndromes are blood cancers in which your bone marrow doesn’t make enough healthy blood cells. The bone marrow makes irregular cells.”
Red blood cells are affected by irregular cells and reduce their numbers. This can lead to anemia.
Anemia caused by MDS can cause serious problems. In this article, we will cover the symptoms of anemia in MDS, why it happens, and how it is treated.
If you have anemia with MDS, some of the symptoms that you may experience include:
- The breath was very thin.
- dizziness or lightheadedness
- There is a throbbing head.
- pale skin
- cold hands and feet
- There is chest pain.
- a heartbeat that’s irregular or too fast (arrhythmia)
Other MDS symptoms
White blood cells and platelets are two types of blood cells that have low counts.
Low WBC counts lower your resistance to infections. Because of this, you may notice that you develop frequent infections that are often more severe.
Platelets help your blood to clot. When your platelet levels are too low, you can have symptoms like:
- easy bruising or bleeding
- frequent nosebleeds
- The gums are bleeding.
- red or purple spots under the skin (petechiae)
In MDS, many of the blood cells made in the bone marrow are irregular (dysplastic). These irregular blood cells don’t function properly and often die much earlier than healthy blood cells.
MDS is also associated with high levels of immature blood cells called blasts. Although a small number of blasts can be found in healthy people, they can make up 5 to 19 percent of cells in the bone marrow of individuals with MDS.
In MDS, irregular and immature cells crowd out healthy blood cells, lowering their numbers. When this impacts RBCs, anemia can result. According to the
Stem cells that are altered in the genetic or chromosomal region can become blood cells. These changes can be either inherited or acquired.
The genetic or chromosomal changes in MDS stop the stem cells in the bone marrow from developing as they should. A
At some point, many people with MDS will have anemia, which is a deficiency of red blood cells.
If you’ve been diagnosed with MDS and begin having symptoms of anemia, contact a doctor to discuss them. The doctor will order blood tests to check your RBC count.
A doctor may want to test for levels.
- hemoglobin, a protein that carries oxygen in your RBCs
- reticulocytes, immature cells that eventually become RBCs
- The hormone erythropoietin stimulates the production of the red blood cells.
The doctor will recommend treatments if your test results show anemia symptoms. They will listen to any questions or concerns you may have and go over the benefits, drawbacks, and side effects of each.
Follow your treatment plan. Many people become resistant to some of the drugs prescribed for them.
“If your medication doesn’t seem to work, you should talk to the doctor. They can help you find alternative treatment options that may work.”
Anemia due to MDS is treated with care. Supportive care helps ease symptoms and improves blood counts.
There are some treatments for MDS.
- Erythropoiesis-stimulating agents. Receiving an injection of factors that promote the production of RBCs can help stimulate your bone marrow to make more. Examples include epoetin alpha (Epogen, Procrit) and darbepoetin alfa (Aranesp).
- Blood transfusions. During a blood transfusion, you’ll receive healthy blood from a donor with a matching blood type. However, frequent blood transfusions can cause iron levels to rise, which can impact organ function. Iron chelation therapy may be used in these cases and involves drugs that bind to excess iron and allow your body to properly remove it.
- Lenalidomide (REVLIMID). Lenalidomide is an immunomodulator that helps your body target irregular bone marrow cells and produce healthy ones. Some MDS patients have a deletion in the long arm of chromosome 5, which is associated with acute myeloid leukemia (AML). Lower-risk MDS patients with this deletion have responded well to treatment with lenalidomide.
- Luspatercept (Reblozyl). Luspatercept is an injectable biologic medication approved for use for MDS anemia if the above treatments aren’t effective. This drug works by stimulating RBCs to mature.
- Hypomethylating agents. DNA methylation is when small chemical groups (methyls) attach to a DNA molecule. These groups don’t change the structure of the DNA but instead affect its activity. Hypomethylating agents aim to reprogram or adjust DNA gene expression to stop cancer cell growth and spread.
- IV decitabine (Dacogen) or azacitidine (Vidaza) are considered lower-intensity chemotherapy drugs and are FDA approved to treat MDS. They are often referred to as DAC and AZA. Through different processes, both can result in the reactivation of tumor-suppressor genes that can help stop cancer cell growth.
- The FDA approved an oral combination of decitabine and cedazuridine to treat MDS.
- Azacitidine (Onureg) and venetoclax (Venclexta) were recently granted breakthrough therapy status by the FDA in treating intermediate-to-high-risk MDS. This means the clinical trials are prioritized. Currently, this regimen is not used outside trials.
- Allogeneic stem cell transplantation (allo-SCT). This is the only curative treatment for MDS and is usually only used in younger people with MDS since it has a higher rate of complications. Allo-SCT involves a patient receiving a high dose of chemotherapy and then an infusion of blood-forming stem cells from a donor. A potentially serious complication of this is graft vs. host disease.
Some patients can achieve transfusion independence by using medications, which means they no longer have to receive regular blood transfusions.
It’s important to treat anemia in MDS. When left unmanaged, anemia can cause cardiovascular complications, like heart failure. This is because low levels of RBCs mean the heart has to work harder to supply your body with oxygen.
But treating anemia in MDS can be challenging. A
Iron can accumulate in the body from blood transfusions. This can necessitate further treatment with iron chylation therapy and higher healthcare costs.
RBC levels are also one of the factors used to predict the outlook for MDS. The
- The levels of blood cells.
- The percentage of blasts in the bone marrow.
- Which types are present, and whether any changes are present.
Once all factors are scored, a risk group is assigned. These groups assess the risk of progression to acute myeloid leukemia (AML), as well as overall survival time. Risk groups can help your doctor decide what initial therapy to use.
The table below shows the median survival time for each of the IPSS-R risk groups, according to the
|IPSS-R risk group||Median survival time|
|very low||8.8 years|
|very high||0.8 years|
“These numbers are for patients who didn’t have access to chemotherapy years ago. Every individual is different and disease progression can be difficult to predict.”
Anemia is a common finding in MDS. It happens when irregular and immature blood cells crowd out healthy RBCs, lowering their numbers. Symptoms of anemia can include fatigue, weakness, and The breath was very thin..
Treatments foremia due to MDS include erythropoiesis-stimulating agents and blood transfusions. These help to increase the levels of healthy red blood cells in the body.
“When there is no treatment for anemia, there can be serious consequences. If you notice symptoms of your disease, or if your current treatment plan isn’t effective, you should make an appointment with your doctor.”