As cancer treatments improve, survivors are living longer. The treatments, unfortunately, put some survivors at risk for secondary conditions. About 13,000 cancer survivors in the United States are diagnosed with myelodysplastic syndrome (MDS) each year, typically after receiving radiation or chemotherapy. While these treatments don’t directly cause MDS, they put patients at a higher risk for the disease over time, as the number of new diagnoses is on the rise each year.
Gabrielle Meyers, M.D., a hematologist and oncologist with the Knight Cancer Institute, is working to better understand how chemotherapy impacts bone marrow, making patients more vulnerable to MDS.
Her work received a boost when she won The Leukemia & Lymphoma Society’s Oregon and Southwest Washington Woman of the Year fundraiser in June 2014 by raising nearly $54,000 for a LLS-funded research project that will study MDS. She shared some insights into the latest thinking about MDS and what cancer survivors should know.
Why are cancer survivors at risk for developing MDS?
MDS occurs when the bone marrow stem cells have been damaged—usually following chemotherapy or radiation—so that they no longer function normally. Ultimately, there is a risk of this turning into leukemia.
Prior treatment with certain chemotherapies is the most important risk factor for MDS in cancer survivors; the National Cancer Institute provides a list of chemotherapies most frequently associated with MDS. Combining these treatments with radiation further increases the risk of MDS. While some cases of MDS are linked to known risk factors, the cause is unknown in many patients.
There is no medicine that reverses the damage to bone marrow cells; patients are generally given medications to help MDS-afflicted cells function well enough to sustain a bone marrow transplant. While Knight Cancer researchers are looking for ways to prevent MDS after chemotherapy, a transplant is currently the only known cure.
What are the symptoms?
Symptoms of MDS include shortness of breath, feeling tired, paler-than-usual skin and easy bruising. The disease does not always cause obvious symptoms and is usually found during routine blood tests.
What is OHSU doing to combat MDS?
To fully understand how chemotherapy damages bone marrow cells, Knight Cancer Institute researchers are studying blood and bone marrow samples from patients exposed to chemotherapy and radiation and have a diagnosis of MDS or leukemia.
Researchers are also studying new treatments that might be combined with MDS drugs to make the afflicted cells function better.
What advances are we seeing in clinical care for patients who suffer from MDS?
Each patient is impacted by MDS in a unique way. Focusing on what drives the MDS cells in a specific patient, and ultimately understanding why it turns to leukemia, will help physicians make better choices in treatment and have newer drugs that target the problem.
The Knight Cancer Institute is conducting research trials designed to better understand MDS. One study explores whether a combination of Busulfan—a drug used to treat leukemia—and reduced chemotherapy is safe and effective for MDS patients; another ongoing study compares the quality of life in patients who receive a less aggressive combination of chemotherapy and/or radiation before a transplant to patients receiving more aggressive therapies.