Bone marrow failure in the elderly

MDS is often referred to as a “bone marrow failure disorder”. MDS is primarily a disease of the elderly (most patients are older than age 65), but MDS can affect younger patients as well. To help you better understand MDS, it might be helpful to first consider some basics about bone marrow and blood.

  • Myelodysplastic Syndromes (MDS) are a group of diverse bone marrow disorders in which the bone marrow does not produce enough healthy blood cells. MDS is often referred to as a “bone marrow failure disorder”. MDS is primarily a disease of the elderly (most patients are older than age 65), but MDS can affect younger patients as well.

How long can you live with bone marrow failure?

With current treatments, patients with lower-risk types of some MDS can live for 5 years or even longer. Patients with higher-risk MDS that becomes acute myeloid leukemia ( AML ) are likely to have a shorter life span. About 30 out of 100 MDS patients will develop AML .

What are the symptoms of bone marrow failure?

The two most common signs and symptoms of bone marrow failure are bleeding and bruising . Blood may be seen throughout the gums , nose or the skin, and tend to last longer than normal. Children have a bigger chance of seeing blood in their urine or stools, which results in digestive problems with an unpleasant scent.

How is MDS treated in the elderly?

Supportive care is important regardless of whether a person is getting other treatments for MDS . If other treatment is needed, a chemotherapy drug such as azacitidine (Vidaza) or decitabine (Dacogen) is often the first choice, especially for patients with lower-risk forms of MDS .

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How long can you live with MDS without treatment?

Survival statistics for MDS

WPSS Risk Group Median Survival Risk of AML (within 5 years )
Low 5.5 years 14%
Intermediate 4 years 33%
High 2.2 years 54%
Very high 9 months 84%

What is the life expectancy after a bone marrow transplant?

Some 62% of BMT patients survived at least 365 days, and of those surviving 365 days, 89% survived at least another 365 days. Of the patients who survived 6 years post-BMT, 98.5% survived at least another year.

What is the life expectancy of someone with aplastic anemia?

Aplastic anemia is a life -threatening condition with very high death rates (about 70% within 1 year) if untreated. The overall five-year survival rate is about 80% for patients under age 20. In recent years, the long-term outcomes of aplastic anemia patients have been continuously improving.

What causes bone marrow to stop producing blood cells?

The most common cause of aplastic anemia is from your immune system attacking the stem cells in your bone marrow . Other factors that can injure bone marrow and affect blood cell production include: Radiation and chemotherapy treatments.

Can bone marrow repair itself?

It can replace diseased, nonfunctioning bone marrow with healthy functioning bone marrow . This is used for conditions such as leukemia, aplastic anemia, and sickle cell anemia. It can regenerate a new immune system that will fight existing or residual leukemia or other cancers not killed by chemotherapy or radiation.

How is bone marrow failure diagnosed?

Diagnosis Blood tests . Normally, red blood cell, white blood cell and platelet levels stay within certain ranges. In aplastic anemia all three of these blood cell levels are low. Bone marrow biopsy. A doctor uses a needle to remove a small sample of bone marrow from a large bone in your body, such as your hipbone.

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How do you know when MDS is getting worse?

Symptoms of MDS For most people, symptoms are mild at first and slowly get worse . They can include: weakness, tiredness and occasional breathlessness (because of the low number of red blood cells) frequent infections (because of the low number of white blood cells)

How do MDS patients die?

Death from MDS is often caused by bleeding and/or infection from low blood cell counts or after the disease becomes acute myeloid leukemia (AML). About a third of patients with MDS develop AML. It is important to remember that statistics on MDS are an estimate.

What is the best treatment for MDS?

Both azacitidine and decitabine are approved by the U.S. Food and Drug Administration (FDA) to treat all types of MDS. However, these drugs are used most often for patients with higher IPSS-R scores. Both can be given in the doctor’s office or clinic.

What are the stages of MDS?

WHO Classification System for MDS Subtypes MDS with single-lineage dysplasia ( MDS -SLD) one or two cytopenias in the blood. MDS with multilineage dysplasia ( MDS -MLD) one to three cytopenias in the blood. MDS with ring sideroblasts ( MDS -RS) MDS with isolated del(5q) MDS with excess blasts ( MDS -EB)

How long can an elderly person live with leukemia?

A few population-based studies have reported 3-year survival rates of only 9-10% and 5-year survival of 3-8% in patients aged 60 years and older, compared with 5-year survival rates of up to 50% for younger patients.

What happens when MDS turns into leukemia?

In MDS , some cells in the bone marrow don’t grow like they should, so there aren’t enough of some types of blood cells. This makes it hard for the body to work the way it should. Some people with MDS go on to get leukemia , a cancer of the bone marrow in which blood cells start to grow out of control.

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