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NCI/PDQ^® Patients: Myelodysplastic/Myeloproliferative Diseases

National Cancer Institute
Ultima Vez Modificado: 19 de julio del 2005

TABLE OF CONTENTS

• Description
  • What are myelodysplastic/myeloproliferative diseases

• Stage Explanation
  • Stages of myelodysplastic/myeloproliferative diseases

• Treatment Option Overview
  • How myelodysplastic/myeloproliferative diseases are treated
  • Treatment by type

• Chronic Myelomonocytic Leukemia

• Juvenile Myelomonocytic Leukemia

• Atypical Chronic Myelogenous Leukemia

• Myelodysplastic/Myeloproliferative Disease, Unclassifiable

• Changes to This Summary (07/19/2005)

• To Learn More

• About PDQ®

Description

What are myelodysplastic/myeloproliferative diseases

Myelodysplastic/myeloproliferative diseases (MDS/MPD) are diseases of the bone marrow that have shared characteristics of both myeloproliferative disorders and myelodysplastic syndromes.

Myeloproliferative disorders are diseases in which too many of certain types of blood cells are made in the bone marrow. The bone marrow is the spongy tissue inside the large bones in the body. The bone marrow makes red blood cells (which carry oxygen to all the tissues in the body), white blood cells (which fight infection), and platelets (which make the blood clot). (Refer to the PDQ® summary on Chronic Myeloproliferative Disorders Treatment for more information.)

Myelodysplastic syndromes, also called preleukemia or smoldering leukemia, are diseases in which the bone marrow does not function normally and not enough normal blood cells are made. Normally, bone marrow cells called blasts develop (mature) into several different types of blood cells that have specific jobs in the body. (Refer to the PDQ® summary on Myelodysplastic Syndromes Treatment for more information.)

MDS/MPD are divided into the following 4 categories:

• Chronic myelomonocytic leukemia:

  Chronic myelomonocytic leukemia is a disease in which too many myelomonocytes (a type of white blood cell that has properties of both a that has properties of both a monocyte and a and a granulocyte) are in the ) are in the bone marrow, crowding out other normal , crowding out other normal blood cells, such as , such as red blood cells and and platelets. .

• Juvenile myelomonocytic leukemia:

  Juvenile myelomonocytic leukemia is a disease in which too many myelomonocytes are in the bone marrow, crowding out other normal , crowding out other normal blood cells. This form of . This form of leukemia is very rare, has unique features that separate it from is very rare, has unique features that separate it from chronic myelomonocytic leukemia, and usually occurs only in very young children. Children , and usually occurs only in very young children. Children diagnosed with with neurofibromatosis 1 are at an increased risk for developing juvenile myelomonocytic leukemia. are at an increased risk for developing juvenile myelomonocytic leukemia.

• Atypical chronic myeloid leukemia:

  Atypical chronic myeloid leukemia is a disease in which too many immature bone marrow cells develop into a type of develop into a type of white blood cell called called granulocytes. Some of these bone marrow cells never become mature white blood cells. These are called Some of these bone marrow cells never become mature white blood cells. These are called blasts. Over time, the granulocytes and blasts crowd out the . Over time, the granulocytes and blasts crowd out the red blood cells and and platelets in the bone marrow. in the bone marrow.

• Myelodysplastic/myeloproliferative disease, unclassifiable (MDS/MPD-U):

  MDS/MPD-U are diseases of the bone marrow or or blood cells that have similar features or presentations of that have similar features or presentations of myelodysplastic syndromes or or myeloproliferative disorders but do not meet the criteria of the major types of MDS/MPD. but do not meet the criteria of the major types of MDS/MPD.

If there are symptoms, a doctor will order blood tests to count the numbers of each of the different types of cells in the blood. If the results of the tests are not normal, more blood tests may be done. The doctor may also do a bone marrow biopsy. During this test, a needle is inserted into a bone to take out some of the marrow. The marrow is then looked at under a microscope. The doctor can then tell what kind of disease the patient has and plan the best treatment.

Stage Explanation

Stages of myelodysplastic/myeloproliferative diseases

There is no staging for these diseases. Treatment depends on the type of myelodysplastic/myeloproliferative disease the patient has.

Treatment Option Overview

How myelodysplastic/myeloproliferative diseases are treated

There are treatments for all patients with myelodysplastic/myeloproliferative diseases. Usually the diseases cannot be cured, but the symptoms can be controlled and the number of blood cells can be reduced with treatment.

Chemotherapy:

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the spinal column, a body cavity such as the abdomen, or an organ, the drugs mainly affect cancer cells in those areas. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Biologic therapy:

Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

High-dose chemotherapy with bone marrow or peripheral blood stem cell transplantation:

A method of giving very high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood of the patient or a donor and are frozen for storage. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. Over a short time, these reinfused stem cells grow into (and restore) the body's blood cells.

Treatment by type

Treatment for myelodysplastic/myeloproliferative diseases depends on the type of myeloproliferative disorder, whether the patient has symptoms or not, and the patient's age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Most patients with myeloproliferative disorders are not cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for the myelodysplastic/myeloproliferative diseases. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Chronic Myelomonocytic Leukemia

Treatment may be one or more of the following:

• Bone marrow or peripheral stem cell transplantation.
• Chemotherapy to lower the number of platelets in the blood.
• Biologic therapy.

Juvenile Myelomonocytic Leukemia

Treatment may be one or more of the following:

• Bone marrow or peripheral stem cell transplantation with or without chemotherapy.
• Chemotherapy to lower the number of platelets in the blood.
• Biologic therapy.

Atypical Chronic Myelogenous Leukemia

Patients will probably receive treatment to relieve symptoms of the disease, such as anemia or bleeding. They may also choose to take part in a clinical trial of chemotherapy or biologic therapy.

Myelodysplastic/Myeloproliferative Disease, Unclassifiable

Patients will probably receive treatment to relieve symptoms of the disease, such as anemia or infection. They may also choose to take part in a clinical trial of chemotherapy or biologic therapy.

Changes to This Summary (07/19/2005)

The PDQ® cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary and links to the NCI Dictionary of Cancer Terms were added..

To Learn More

Call

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Web sites and Organizations

The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. There are also many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment.

Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

LiveHelp

The NCI's LiveHelp service, a program available on several of the Institute's Web sites, provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write

For more information from the NCI, please write to this address:

• NCI Public Inquiries Office
• Suite 3036A
• 6116 Executive Boulevard, MSC8322
• Bethesda, MD 20892-8322

About PDQ®

PDQ® is a comprehensive cancer database available on NCI's Web site.

PDQ® is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ® is available online at NCI's Web site. PDQ® is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ® contains cancer information summaries.

The PDQ® database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ® cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ® also contains information on clinical trials.

Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."

Listings of clinical trials are included in PDQ® and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ®. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.