Symptoms of Myelodysplastic Syndrome

When it comes to myelodysplastic syndrome, many people may not know much about it. Although it is a relatively uncommon disease, we should also pay more attention to it. Myelodysplastic syndromes (MDS) are a group of heterogeneous myeloid clonal diseases originating from hematopoietic stem cells, characterized by abnormal differentiation and development of myeloid cells, manifested as ineffective hematopoiesis, refractory cytopenia, hematopoietic failure, and a high risk of transformation to acute myeloid leukemia (AML).

MDS treatment mainly addresses two major problems: bone marrow failure and complications, and AML transformation. In terms of patient populations, the natural course and prognosis of MDS patients vary greatly, and treatment should be individualized. The conversion rate to whiteness varies among different subtypes. The biological characteristics of some patients are relatively indolent, with a longer course of disease and a very low conversion rate to whiteness.

symptom

1. Symptoms: The clinical manifestations of MDS are not specific. MDS usually has a slow onset, but in some cases, it has an acute onset. Generally, the rate of transformation to leukemia is more than 50% within one year from the onset of the disease. 90% of patients suffer from anemia. These include pale complexion, fatigue, palpitations after activity, and shortness of breath. Anemia in the elderly often aggravates existing chronic heart and lung diseases. Severe granulocytosis can reduce the patient's resistance. Bleeding accounts for 20%, which is common in the respiratory tract, digestive tract, and also intracranial hemorrhage. The early bleeding symptoms are mild, mostly skin and mucous membrane bleeding, gum bleeding or epistaxis. Female patients may have excessive menstruation. The bleeding trend worsens in the late stage, and cerebral hemorrhage becomes one of the main causes of death in patients. Severe thrombocytopenia can cause skin bruises, nosebleeds, bleeding gums and internal bleeding. A small number of patients may have symptoms such as joint swelling and pain, fever, skin vasculitis, etc., often accompanied by autoantibodies, similar to rheumatism.

2. Physical signs: The physical signs of MDS patients are atypical. The patient often has pale complexion due to anemia and petechiae and ecchymoses on the skin due to thrombocytopenia. About 10% of patients suffer from hepatosplenomegaly. Very few patients may have lymphadenopathy and skin infiltration, most of whom are chronic myelomonocytic leukemia (CMMoL) patients. For patients suspected of having mastocytosis or thrombocytosis, detection of KIT gene D816V mutation or JAK2 gene V617F mutation is helpful for differential diagnosis.