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Doctors' Answers to "Frequently Asked Questions" - Myelodysplasia

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 11/24/1999]
Question: My wife's grandfather was recently diagnosed with myelodysplasia.
He was prescribed Vitamin B6 some time ago, which did not
work, and was recently prescribed fluoxymesterone. I understand
this is a male hormone but we are all unclear on the advantages
of taking this prescription and the side effects, if any, it
may produce. Can you clarify this for us?

Answer: This is an attempt to "turn on" the marrow which this hormone can do on occasion. There are some potential liver toxicity issues, easily followed. But, if it turns on his marrow, it is worth the risk since we have so few/no drugs that work very well in this situation.

Question: My mother has been diagnosed with myelodysplastic syndrome anemia. I read that recombinant human erythropoietin could be helpful in treating myelodysplasia. Is this true? Also, are there any other treatments available or recommended?

Answer: Myelodysplasia describes a large group of anemias (low blood counts). There is a classification system called FAB which includes five groups: 1. Refractory anemia. 2. Refactory anemia with ringed sideroblasts. 3. Refactory anemia with Blasts. 4. Chronic myelomonocytic leukemia 5. Refactory anemia with Blasts in Transformation. This type of anemia is usually seen in people over 50 and survival is extremely variable. Occasionally these transform into a different type of leukemia altogether. Treatment is not aimed at correcting or preventing the anemia, but support only. This means transfusions as necessary, treatment of infections, etc. Some patients will respond to pyrodoxine (Vitamin B6) so this is usually tried. Bone marrow transplantation and stimulation(with epogen) is occasionally effective. There are different protocols under study by the NIH including human hematopoietic growth factors, etc.

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