Talk:Myelodysplastic syndrome

From WikiProjectMed
Jump to navigation Jump to search

Could

Could be wrong here, but isn't there a possiblility of a complete recovery in the rare cases where a patient is young enough to have a bone marrow transplant and it goes well? If so, this paragraph

The best prognosis is seen with refractory anemia with ringed sideroblasts and refractory anemia, here some patients live more than a decade (the average is on the order of 3-5 years); the worst outlook is with RAEB-T, where the mean life expectancy is less than 1 year. About 1/4 of patients develop overt leukemia. The others die of complications of low blood count or unrelated disease.

should definitely mention it. CTOAGN 15:09, 5 October 2005 (UTC)[reply]

I am not up-to-date with the rate of CR in transplant recipients for MDS. The fact that they are transplanted when young suggests that CR with long-term remissions are feasible. If I come accross the relevant stats I will update the page. JFW | T@lk 06:34, 6 October 2005 (UTC)[reply]

Thanks for replying. I don't want to edit the article myself (I'm not a medic and don't like the idea of non-medics editing these articles) but would like it to be mentioned. I found Wikipedia by googling for MDS after being diagnosed with it at 29, and reading the above was something of an experience. Fortunately I already knew that the vast majority of MDS patients were elderly and many of them had it as a secondary illness, and assumed that was one of the reasons for the short life expectancy, but someone who didn't know that would have found it very upsetting. CTOAGN 18:43, 6 October 2005 (UTC)[reply]

Perhaps Andrew73 may be able to help. He's more into haematology than I am at the moment. JFW | T@lk 23:22, 13 October 2005 (UTC)[reply]
I expanded the therapy section a little bid. Treatment with BMT can be curative, but I agree that when you read the description of MDS, it can be disheartening. What complicates things is that it is heterogeneous condition, so it can be hard to give specifics about prognosis. Andrew73 01:30, 17 October 2005 (UTC)[reply]

Is it necessary also to include the 5q- syndrome and unclassifible into the classification? --Calvinchong 03:47, 9 December 2005 (UTC)[reply]


Prognosis

I really appreciate the effort that's gone into the article, but I've got a couple more suggestions: The article still reads a bit along the lines of "if you've got myelodysplasia, it's going to kill you". The possibility of long term remission isn't mentioned until quite late in the article, after such sentences as "The others die of complications of low blood count or unrelated disease" (I assume this sentence refers to RAEB-T but that's not completely obvious and I read it as referring to MDS in general when I first read the article). I've taken the liberty of editing the intro, and I'd really appreciate it if someone who knows what they're talking about could refine what I've written.

I've edited the intro and toned down the intro's bleak tone as wlel as the section about patients running into difficulties with bleeding or infection. The prognosis and the possibility for long term remission is best determined by the IPSS score (cytogenetics, number of neutropenias), so I figured it was best to mention the prognosis during that section, rather than upfront in the article. Andrew73 02:38, 29 December 2005 (UTC)[reply]
Having read it again, I have to disagree. To someone recently diagnosed with this illness, that reads as "You have no more than ten years to live." Fair enough if it were true, but if there's any possiblity at all of someone living longer it needs to mentioned as soon as life expectancy is mentioned. A patient would be quite likely to stop reading there, and miss the bit about transplants further down. After my experience of reading this article immediately after diagnosis I think it's vital to mention it early on - if you haven't discussed life expectancy with a doctor you don't want to read that things are even worse than they really are. CTOAGN (talk) 19:43, 14 April 2006 (UTC)[reply]
I concur. My father was given MDS as a possible diagnosis. He visited the Wiki for MDS, but as a non-Wiki user, decided to believe his friends who told him that Wiki isn't accurate because anyone can edit it. I believe that reaction happened due to the way the Prognosis section is written. I think in medical articles, authors should be careful to remember the audience. I believe circumstances like this are more likely to get 1st time readers to Wiki, and if they don't like what they see, they'll steer away from it. I agree that the possibility of long-term remission should at least be mentioned in the intro, but at least mentioned shortly after prognosis. Also, as most people first hear of MDS when they are possibly diagnosed with it, maybe the intro could mention potential 'other' conditions which may appear similar or need to be ruled out. — Preceding unsigned comment added by 216.23.197.250 (talk) 17:56, 24 October 2012 (UTC)[reply]

My boyfriend has had MDS twice now. He was 13 the first time and had a bone marrow transplant and beat it.. now again just recently was diagnosed with it again at the age of 19. He beat it again with another bone marrow transplant.. he is almost a year post transplant now and he is doing terrific. so i have to say that they have come a long way with life expectancy taylor is said to live a long and happy life as long as he stays in remmision :D —Preceding unsigned comment added by 64.77.211.19 (talk) 04:24, 3 November 2010 (UTC)[reply]

Also, the second Diagnosis section is somewhat incomprehensible to a non-medic. I realise it's probably difficult to avoid jargon to some extent with a subject like this, but phrases such as "Erythroid nuclear budding" don't explain the condition to me at all. Do you think it would be possible to explain what's being referred to in a more accessible way?

Thanks, File:Yemen flag large.png CTOAGN (talk) 04:15, 28 December 2005 (UTC)[reply]

This article was accurate and had been reviewed by a doctor. This edit http://en.wikipedia.org/w/index.php?title=Myelodysplastic_syndrome&diff=33071524&oldid=33059002 deletes significant facts about the seriousness of the disease and its prognosis. This is WP:CENSOR It violates the Wikipedia rule against deleting accurate information. People who look up their diseases on the Internet want the facts. If they don't realize how serious it is, they may not go to the doctor. If you were to delete everything from Wikipedia medical articles that made people upset, we wouldn't have reliable, useful information. I'm not going to revert it, because that information may not be current, but when I find current information on prognosis, I'll return it into the entry. --Nbauman (talk) 17:14, 31 August 2012 (UTC)[reply]

Malignant or not?

Is MDS considered a malignant (cancerous) disease or not? --Spiff666 (talk) 15:24, 3 June 2008 (UTC)[reply]

It's considered premalignant.[1]. It's not "benign" but it's not frankly malignant either. WhatamIdoing (talk) 16:06, 9 June 2008 (UTC)[reply]

Diagnosis * 2

There are two 'Diagnosis' sections! The second one looks highly technical and perhaps isn't appropriate for WP? —Preceding unsigned comment added by Amilnerwhite (talk • contribs) 03:57, 11 November 2009 (UTC)[reply]

Accessibility

O-kay then, let's see about accessibility issues....Casliber (talk · contribs) 23:01, 18 January 2011 (UTC)[reply]

  • First sentence is a doozy - can we replace "hematological conditions" with "blood disorders"? Or are we losing meaning?
  • MDS has been found in humans... - and we've gone singular here. Maybe "These conditions.." allows us to keep plural.
  • chronic blood transfusion.. - periodic ongoing blood transfusions? ("chronic" always makes me think of a disease rather than treatment)
  • Myelodysplastic syndromes are bone marrow stem cell disorders resulting in disorderly and ineffective hematopoiesis (blood production), manifested by irreversible quantitative and qualitative defects in hematopoietic (blood-forming) cells. -->

"Myelodysplastic syndromes are bone marrow stem cell disorders - hematopoiesis (blood production) is compromised, resulting in fewer (alt= lower numbers of) and defective (blood-forming) cells." (or "defective and lower numbers of cells")

Note to self (and others)

Reference for link between radiation exposure and MDS incidence: [2]. MastCell Talk 23:47, 28 January 2011 (UTC)[reply]

Animals

"MDS has been found in humans, cats and dogs." Apart from its curious construction, this sentence would also suggest that MDS does not occur in other animals, which it does (rats, mice, rabbits etc.), so I have removed it.

Epidemiology

"The exact number of people with MDS is not known because it can go undiagnosed and there is no mandated tracking of the syndrome" - this statement is not really accurate. I work for a state public health department and we do require these cases to be reported to us by hospitals, physicians, etc. the cases are then reported (along with other cancer cases) to the CDC annually. — Preceding unsigned comment added by Dojodan (talk • contribs) 19:08, 25 August 2011 (UTC)[reply]

Diagnostic tests: Add FISH MDS panel

Diagnosis section is currently missing mention of FISH testing for MDS which is commonly ordered when MDS is suspected (It is mentioned in "Prognosis" section). — Preceding unsigned comment added by Dosware (talk • contribs) 05:45, 11 December 2012 (UTC)[reply]

Review

On molecular pathogenesis doi:10.1111/bjh.12435 JFW | T@lk 21:37, 17 August 2013 (UTC)[reply]

European review: doi:10.1182/blood-2013-03-492884 JFW | T@lk 22:08, 27 October 2013 (UTC)[reply]
doi:10.1111/bjh.12694 is a new British guideline on diagnosis and management. JFW | T@lk 16:12, 24 December 2013 (UTC)[reply]
Lancet: doi:10.1016/S0140-6736(13)61901-7 JFW | T@lk 21:23, 6 July 2014 (UTC)[reply]
Response criteria, international criteria doi:10.1182/blood-2014-10-607341 JFW | T@lk 10:44, 23 March 2015 (UTC)[reply]

i'dsayMYELODYSPLASIA=syn

rdircthere2?81.11.218.243 (talk) 14:34, 9 December 2016 (UTC)[reply]

gramr

do not mature Nor? become healthy blood cells. 81.11.218.243 (talk) 14:45, 9 December 2016 (UTC)[reply]

itsMDSs<plural!

81.11.218.243 (talk) 20:24, 9 December 2016 (UTC)[reply]

RAMD=?

@unclasified — Preceding unsigned comment added by 81.11.218.243 (talk) 21:10, 9 December 2016 (UTC)[reply]

sth.misin?

Other stains can help in special cases (PAS and napthol ASD chloroacetate esterase positivity) in eosinophils is a marker of abnormality seen in chronic eosinophilic leukemia and is a sign of aberrancy.213.49.104.55 (talk) 15:53, 11 December 2016 (UTC)[reply]

Spleen or kidney?

In the second photo which accompanies the "Signs and symptoms" heading: is not the smaller organ (in green) the spleen, and the larger organ (in red) the kidney? Please correct me if I'm mistaken. — Preceding unsigned comment added by 96.54.252.250 (talk) 13:28, 6 January 2018 (UTC)[reply]

Other names

Ref says "Myelodysplasia and myelodysplastic syndrome (9989/3) are not the same disease. Myelodysplasia may be used as an alternate names for myelodysplastic syndrome"[3]

So basically some people use the term myelodysplasia to mean MDS but such usage is not the best as myelodysplasia also has other meanings. Doc James (talk · contribs · email) 08:26, 23 May 2019 (UTC)[reply]

Here is another ref that supports.[4] Doc James (talk · contribs · email) 08:28, 23 May 2019 (UTC)[reply]

Pathofysiology

The mechanism by which the dysplasia results remains unexplained. All it mentions is that DNA methylation is involved. Too much, too few? We know MDS responds in certain conditions to epigenetic medication like azacitidine, decitabine, lenalidomide, but the article fails to explain why that is. — Preceding unsigned comment added by Smoutezot (talk • contribs) 15:56, 21 December 2020 (UTC)[reply]

Reading through the Genetics section, this seems adequately explained to me and in line with our lack of knowledge about the exact causes of MDS (as explained throughout the article), though there's a lack of citations in the first paragraph and the three paragraphs above. As far as "too much, too few," there's mention of "disordered" methylation, and that the drugs you listed are hypomethylating agents. As the section states, "Proper DNA methylation is critical in the regulation of proliferation genes, and the loss of DNA methylation control can lead to uncontrolled cell growth and cytopenias," I think this level of detail is perfectly fine for an article here (though more citations are needed). Global Cerebral Ischemia (talk) 18:28, 21 December 2020 (UTC)[reply]

Newer Treatment

Luspatercept (Reblozyl) has been successfully used to decrease transfusion dependency. Maybe someone would like to research this and add it to the treatment section. Thanks and may we stay happy, healthy and peaceful!!! 2600:8800:7181:3AA:D073:E690:ABA9:EF41 (talk) 03:05, 12 July 2022 (UTC)[reply]

Leukopenia listed as a different cause?

Re "differentiating MDS from anemia, thrombocytopenia, and leukopenia is important", aren't anemia (reduced oxygen carrying capacity), thrombocytopenia (low platelet count) and leukopenia (low white cell count) more symptoms of disease than causes / diseases? 2600:100F:B1B4:ED0B:BE5A:4198:7F0F:8AD9 (talk) 17:41, 14 October 2023 (UTC)[reply]

Retrieved from "https://mdwiki.org/wiki/Talk:Myelodysplastic_syndrome"