Mielodisplasia Syndrome

Myelodisplastic syndrome (MDS) is a number of disorders caused by one or all blood cells produced by bone marrow that have not been formed properly. Myelodysplasia syndrome can affect people of all ages. However, this syndrome most often occurs in adults aged 60 years and over.

Symptoms of myelodysplasia syndrome
In the early stages, myelodysplastic syndrome (MDS) rarely shows signs or symptoms. When symptoms appear, they can usually be:

• Pale due to anemia.
• Infection is often caused by a low number of mature white blood cells.
• Bruising or easy bleeding due to low platelet counts.
• fatigue
• Hard to breathe.
• Red spots under the skin due to bleeding.

Causes of myelodysplasia syndrome

Myelodisplasia syndrome (MDS) occurs when bone marrow function is disrupted. Bone marrow contains spongy tissue that produces red blood cells that carry oxygen throughout the body, white blood cells that help fight infection, and platelets that help thicken the blood.

In people with myelodysplasia syndrome, the bone marrow is unable to produce healthy (adult) blood cells and can only produce abnormal blood cells that do not develop fully. These abnormal blood cells will die when they are still in the bone marrow or when they enter the bloodstream. Over time, the number of abnormal blood cells will increase and suppress the number of healthy blood cells, which will reduce the number of blood cells that enter the blood.

This is caused by genetic modification. Genetic modification that can cause abnormalities in the bone marrow is unknown. Some triggering factors that can cause genetic modification responsible for MDS, namely:

• Growing age. Most people with MDS are over 60 years old.
• Exposure to chemicals such as cigarette smoke, pesticides, and benzene.
• Exposure to heavy metals, such as lead and mercury.
• Treatment with chemotherapy or radiotherapy before. Chemotherapy drugs, such as etoposide, and radiation therapy previously used for cancer treatment can increase the risk of developing MDS.

Diagnosis of Mielodisplasia syndrome
The doctor will ask about your symptoms, check your medical history, and do a physical examination as the first step in diagnosis. Then, the doctor will do a number of tests to determine its effectiveness. Among these are by:

• Blood test. Determine the number of red blood cells, white blood cells and platelets in the body and see if the size, shape and shape of the blood cells have changed.
• Bone marrow aspiration examination (BMP). The doctor will take blood samples directly from plants (bone marrow) to get a picture of the whole blood and genetic tests, as well as bone marrow tissue samples (biopsy) to detect changes in structure. cells in the bone marrow. This procedure is done by inserting a needle into the point behind the pelvic bone. This procedure takes about 15 to 20 minutes.

Treatment of myelodysplasia syndrome
Treatment of myelodysplastic syndrome (MDS) is focused on inhibiting the development of this condition, reducing symptoms and preventing bleeding and infection. The doctor will perform several forms of treatment, including:

• Medicine. Aiming to destroy non-growing blood cells stops their growth. The drug can be in the form of tablets or injections. Examples of drugs used to inhibit the development of MDS are lenalidomide, azacitidine or decitabine.
• Blood cell growth factor injection. To increase the number of healthy red blood cells and maintain normal Hb values, you can use erythropoietin (EPO), such as epoetin alfa. To increase the number of white blood cells, administration of G-CSF, such as filgrastim, is only given in a few cases. At the same time, administration of growth factors to platelets such as eltrombopag can actually increase the number of immature blood cells. Therefore it is not used in the case of SMD.
• Blood transfusion Red blood cell transfusion is a supportive therapy used to increase the number of blood cells and maintain normal Hb values. Although platelet transfusion is only done to stop the bleeding, if bleeding occurs.
• Iron binding treatment. This therapy aims to reduce iron levels in the body because transfusions are too frequent.
• Antibiotics. To defeat infection if the white blood cell count is low.
• Combined chemotherapy. Combined chemotherapy is done when there is an increase in the number of young immature cells or MDS that develop into acute leukemia (blood cancer).
• Bone marrow transplantation. Bone marrow transplantation is recommended for patients aged 55 years and under with uncontrolled MDS. Remember that patients aged 60 years and over are mostly affected by MDS. As a result, bone marrow transplantation is rarely done in cases of disease.

Complications of myelodysplasia syndrome

Complications of myelodysplasia syndrome include:

• anemia
• It is difficult to stop bleeding because of a low platelet count (thrombocytopenia).
• Infections that often occur due to low numbers of adult white blood cells.
• Become acute leukemia (blood cancer).

Prevention of Mielodisplasia syndrome

It is not yet clear how to prevent myelodysplastic syndrome (MDS), but to stop smoking, and to follow health and safety procedures at work (K3) in the workplace, such as the use of personal protective equipment (PPE), can reduce the risk of exposure to chemicals that may be a factor risk for MDS development.

People with MDS tend to have frequent infections due to low white blood cell counts. There are several things you can do to reduce the risk of infection:

• Wash your hands Do it before eating or preparing food. Always carry an alcohol-based hand sanitizer with you instead of soap and water.
• Be careful with the food. Avoid raw food, cook food until completely cooked. Avoid fruits and vegetables that cannot be peeled and wash all the products that you want to eat before peeling the skin.
• Avoid people who are sick. Avoid direct contact with sick people, family members and colleagues.

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