Myelodysplasia

Myelodysplasia affects the growth and development of healthy blood cell formation in your bone marrow. You may also hear it referred to as myelodysplastic syndrome.

Myelodysplasia impacts the production of blood cells and restricts their development. Over time there are more defective blood cells than healthy blood cells, which can cause other symptoms and health conditions such as anaemia.

There are many different kinds of myelodysplasia classified according to the morphology (appearance) and cytogenetic changes of the bone marrow cells. These include:

• Refractory anaemia
• Refractory anaemia with ringed sideroblasts
• Refractory cytopenia with multilineage dysphasia
• Refractory cytopenia with multilineage dysphasia and ringed sideroblasts
• Myelodysplastic syndrome with del(5q) chromosome
• Myelodysplastic syndrome with excess blasts
• Mixed myelodysplastic/myeloproliferative neoplasms

In some cases myelodysplasia can progress to leukaemia.

Myelodysplasia is often suspected based on abnormal blood tests. The first step for diagnosis involves having a blood test which analyses the red blood cells, white blood cells and platelets in your blood, known as a full blood count (FBC) or a complete blood count (CBC). Examination of the blood film under a microscope by an experienced haematologist may reveal abnormalities in the morphology of the blood cells.

For people with myelodysplasia, the blood test may indicate low numbers of platelets and red blood cells (anaemia), and the presence of abnormal white blood cells and leukemic blast cells, which may also indicate leukaemia.

You will then need to have a bone marrow biopsy, which involves having a sample of bone marrow removed (usually from your hip bone). Analysis of the stem cells in the bone marrow, as well as the results from your blood test, confirms the diagnosis.

Treatment for myelodysplasia depends on the type that you have, and your age, medical history and treatment preferences. Options include chemotherapy, stem cell transplantation, the ‘watch and wait’ method, supportive therapy with transfusion and growth factors, immunomodulatory drugs, and accessing new treatments not yet available to the public through clinical trials.