Austin Kulasekararaj Background and Why Described in 1900 Defined as MDS only in 1982abnormal clone dont think it spreads like breast cancer No interest in studying MDS New research novel treatments and more emphasis on disease biology ID: 510078
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Slide1
Myelodysplastic Syndromes
Austin KulasekararajSlide2
Background and Why?
Described in 1900
Defined as MDS only in 1982-abnormal clone (don’t think it spreads like breast cancer)
No interest in studying MDS
New research, novel treatments and more emphasis on disease biologySlide3
What does the term "myelodysplastic" actually mean?
Myelo
= marrow
Dysplastic
= abnormal or just gone bad or funny looking
Bone marrow cells fail to make enough healthy blood cells- quantity and quality is affected.
Crowding out remaining normal cells (Cancer)Slide4
Red Blood Cells 20 trillionSlide5Slide6
MDS features
All people with MDS have two things in common
Low count for at least 1 blood cell type (cytopenia)
Bone marrow and blood contain blood cells with an abnormal shape, size, or look.Slide7
Symptoms of MDS
Asymptomatic – abnormal blood count
Fatigue, lack of energy and shortness of breath
- caused by anaemia (low red cells)
Bruising and bleeding
- caused by low platelet cell count
Infection
- due to low numbers and/or poorly functioning white cells Slide8
Prior exposure to chemo and or radiotherapy, but 90% do not have any known exposures
Median age is @ 72 years
50%
MDS
AML
Infection, Bleeding and treatment complications
Unrelated causes
Clinical Course
Patients
25%
25%Slide9
Cytogenetics
Trephine
Blood film/Aspirate
Flow Cytometry
Bone marrow aspirate and trephine
Ouch
Diagnostic TestsSlide10
Blasts (Type 1 and 2)
Morphology of MDS
RARS
5q-Slide11
Beware of mimics, imposters, copycats and imposters
Vitamin deficiency
Other related disorders (aplastic anaemia)
ICUS (Idiopathic Cytopenia of Unknown Significance)
Nutritional and pharmacological toxicities
Immune related conditions (lupus, rheumatoid and
crohns
/ulcerative colitis)Slide12
MDS-not a single entity
?
RA/RARS
AML
Normal
Pre-MDS/NY/NQ MDS/ ICUS/ IDUS
RAEB-t ?
RAEB 1/2
CMML
MPD/MDS
Hypo
MDS
Time (years)
Clone size
RA /RARS 5q-
RCMD
AA
PNH
AML
Low
Risk
High
Risk
MDS
5q-
AML
MPN (
BCR-ABL
neg
)
CMML
aCML
MDS/MPN-U
JMML
RARS-T
JAK2+
AA
MDS