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    Myelodysplastic Syndromes Treatment (PDQ®): Treatment - Patient Information [NCI] - General Information About Myelodysplastic Syndromes


    Age and past treatment with chemotherapy or radiation therapy affect the risk of a myelodysplastic syndrome.

    Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get a disease; not having risk factors doesn't mean that you will not get a disease. Talk with your doctor if you think you may be at risk. Risk factors for myelodysplastic syndromes include the following:

    • Past treatment with chemotherapy or radiation therapy for cancer.
    • Being exposed to certain chemicals, including tobacco smoke, pesticides, fertilizers, and solvents such as benzene.
    • Being exposed to heavy metals, such as mercury or lead.

    The cause of myelodysplastic syndromes in most patients is not known.

    Signs and symptoms of a myelodysplastic syndrome include shortness of breath and feeling tired.

    Myelodysplastic syndromes often do not cause early signs or symptoms. They may be found during a routine blood test. Signs and symptoms may be caused by myelodysplastic syndromes or by other conditions. Check with your doctor if you have any of the following:

    • Shortness of breath.
    • Weakness or feeling tired.
    • Having skin that is paler than usual.
    • Easy bruising or bleeding.
    • Petechiae (flat, pinpoint spots under the skin caused by bleeding).

    Tests that examine the blood and bone marrow are used to detect (find) and diagnose myelodysplastic syndromes.

    The following tests and procedures may be used:

    • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
    • Complete blood count (CBC) with differential: A procedure in which a sample of blood is drawn and checked for the following:
      • The number of red blood cells and platelets.
      • The number and type of white blood cells.
      • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
      • The portion of the blood sample made up of red blood cells.

      Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions.
    • Peripheral blood smear: A procedure in which a sample of blood is checked for changes in the number, type, shape, and size of blood cells and for too much iron in the red blood cells.
    • Cytogenetic analysis: A test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes.
    • Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as vitamin B12 and folate, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
    • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for abnormal cells.
      Bone marrow aspiration and biopsy. After a small area of skin is numbed, a Jamshidi needle (a long, hollow needle) is inserted into the patient's hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.

      The following tests may be done on the sample of tissue that is removed:

      • Immunocytochemistry: A test that uses antibodies to check for certain antigens in a sample of bone marrow. This type of test is used to tell the difference between myelodysplastic syndromes, leukemia, and other conditions.
      • Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell. This process is used to diagnose specific types of leukemia and other blood disorders by comparing the cancer cells to normal cells of the immune system.
      • Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of cells, such as size, shape, and the presence of tumor markers on the cell surface. The cells are stained with a light-sensitive dye, placed in a fluid, and passed in a stream before a laser or other type of light. The measurements are based on how the light-sensitive dye reacts to the light.
      • FISH (fluorescence in situ hybridization): A laboratory technique used to look at genes or chromosomes in cells and tissues. Pieces of DNA that contain a fluorescent dye are made in the laboratory and added to cells or tissues on a glass slide. When these pieces of DNA bind to specific genes or areas of chromosomes on the slide, they light up when viewed under a microscope with a special light.
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