Be Blood Safe
Rare blood disorders can strike older adults. Here’s all you need to know about them…
Discover the undiscovered blood disorder Senior Care
As an older adult, you’re at higher risk of a group of blood disorders you may not have heard of – MDS(myelodysplastic syndromes), a series of different diseases that affect the function and numbers of blood cells. Complications that can arise from MDS include anemia, infections and excess bleeding. Occasionally, MDS develops into cancer, and studies suggest MDS patients also are at higher risk than other seniors for heart attack and diabetes. Shyamala C Navada, MD, assistant professor of hematology/ oncology at Mount Sinai Medical Centre, US, confirms that MDS is a health issue older adults need to be aware of if they have the risk factors associated with this type of blood disorder. “It’s an important health issue that will likely become a growing problem with the increasing life span of the general population,” Dr Navada says. However, it is important to remember that many MDS patients do well for a long time with supportive treatment.
STEM CELL PROBLEM
MDS develops due to a problem with bone marrow, the soft, fatty tissue found in the hollow interior of certain bones, including the hips, femur, sternum, skull, ribs, vertebrae and shoulder blades. Bone marrow produces stem cells: Immature cells that differentiate (develop) into particular kinds of cells, including the red blood cells that transport oxygen in the body, the white blood cells that fight infection, and the platelets that assist with blood clotting. In MDS, these stem cells don’t mature into healthy, differentiated cells. “They may accumulate in the bone marrow, or they may have a shortened life span, resulting in a decrease in mature blood cells in the circulation,” Dr Navada explains. “In addition, many of the mature blood cells do not function properly.” Over time, the number of immature, defective cells begin to exceed the number of healthy cells, eventually resulting in symptoms such as anemia (marked by shortness of breath, fatigue, and a pale complexion), increased susceptibility to infection, and easy bleeding and/ or bruising. In some patients, MDS can develop into acute myeloid leukemia (AML), a rapidly
MDS can lower your white blood cell count, putting you at risk for infections. Reduce this risk by washing your hands frequently in hot, soapy water, especially before preparing and/ or eating food.
progressing type of cancer that affects immature blood cells.
RISK FACTORS INCLUDE CANCER TREATMENT
You are at higher risk of MDS if you have received prior chemotherapy or radiation, both of which are used to treat other cancers. Also implicated is exposure to tobacco smoke, pesticides, industrial chemicals (notably benzene, which is emitted by burning coal and oil and also is present in motor vehicle exhaust, as well as used in the production of plastics, detergents and pesticides), and heavy metals, including lead and mercury.
NEW TREATMENT HAVING AN IMPACT
Treatment for MDS depends on your symptoms, age, disease stage, disease risk category, and any preexisting conditions. The standard approach is supportive, treating the signs and symptoms of the disease. “Treatments for low-risk MDS include blood transfusions and growth factors, including erythropoietin, which decreases the need for transfusion in approximately 20% of MDS patients,” Dr Navada explains. “In patients who are at intermediate or high risk for complications, lowintensity chemotherapy with medication can improve blood counts, decrease transfusion requirements, reduce the risk for AML, and improve quality of life. These newer drugs have had an impact, and current research is looking at combination strategies to augment response rates.”
STEM CELL TRANSPLANTS AN OPTION
Stem cell transplants also are an option for treating MDS, though the procedure is risky for older adults. “Patients often have comorbidities that preclude them from being a transplant candidate,” says Dr Navada. Standard stem cell transplants also require that existing bone marrow be destroyed, typically via chemotherapy and radiation, and side effects can be severe. A less intense option is a mini-stem cell transplant. “This procedure involves less intensive chemotherapy, and is safer in older patients,” Dr Navada explains. “However, there is an increased risk of relapse compared with normal intensity regimens.”