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Refractory Anemia with Excess Blasts
Refractory Anemia with Excess Blasts Type 1

Presentation

Although the patient presented with highly complex chromosomal abnormalities, his initial clinical presentation was that of typical refractory anemia with excess blasts. Shortly after diagnosis (7 months), the patient developed acute leukemia. [ncbi.nlm.nih.gov]

The number of megakaryocytes is also diminished and there are prominent micro-megakaryocytes present throughout. Iron stores are present and no ringed sideroblasts are seen. The bone marrow is >90% cellular. [gpec.ubc.ca]

[…] simulators (Increased blasts make these less likely) Other myelodysplastic disorders Refractory Anemia with Excess Blasts Acute Myelogenous Leukemia Blasts Blasts frequently ≥20% in peripheral blood and/or bone marrow AML defining translocations not present [surgpathcriteria.stanford.edu]

Anderson presentation. The presentation to treatment interval was greater than 2 months in 1%, 3%, and 4% of the AML, RAEB-t, and RAEB patients, respectively. [bloodjournal.org]

Entire Body System

  • Fatigue

    Symptoms include fatigue, anemia, bleeding, and bruising. The mainstay of treatment is supportive care. [ugr.es]

    The most frequently encountered toxicities were cytopenias, fatigue, hyperglycemia, hypokalemia, hypophosphatemia, and QT prolongation. Dose-limiting toxicities (DLT) were cardiac arrhythmia-atrial fibrillation and QT prolongation. [ncbi.nlm.nih.gov]

    Epidemiology Incidence 35-40% of MDS 15-20% RAEB-1 20% RAEB-2 Associated reticulin fibrosis seen in ˜ 10% of MDS; most are RAEB-F (fibrosis) Age Older individuals, primarily > 50 years of age Presentation Often seek medical attention for symptoms of anemia Fatigue [basicmedicalkey.com]

    Symptoms are referable to the specific cell line most affected and may include fatigue, weakness, pallor (secondary to anemia), increased infections and fever (secondary to neutropenia), and increased bleeding and bruising (secondary to thrombocytopenia [merckmanuals.com]

  • Gangrene

    Reasons for not autografting the six mobilizing patients were early relapse ( n = 2), which occurred in both cases after 2 months from CR achievement, refusal ( n = 1), infection ( n = 2) and severe uncontrolled diabetes resulting in ischemic left foot gangrene [doi.org]

  • Collapse

    Sometimes called a collapsed lung. atezolizumab listen (A-teh-zoh-LIZ-yoo-mab) A drug used to treat certain types of small cell lung cancer, breast cancer, non-small cell lung cancer, and urothelial cancer (a type of bladder cancer). [cancer.gov]

  • Short Stature

    4 Non-diarrheal CD (NDCD) has variable presentation including failure to thrive, short stature, refractory anemia, rickets, vomiting and recurrent oral ulcers. [freethesaurus.com]

Respiratoric

  • Cough

    Symptoms include wheezing, coughing, tightness in the chest, shortness of breath, and rapid breathing. [cancer.gov]

Gastrointestinal

  • Vomiting

    4 Non-diarrheal CD (NDCD) has variable presentation including failure to thrive, short stature, refractory anemia, rickets, vomiting and recurrent oral ulcers. [freethesaurus.com]

    It is also used to prevent nausea and vomiting after surgery. Aprepitant blocks the action of a certain chemical in the brain that may trigger nausea and vomiting. Blocking this chemical may lessen nausea and vomiting. [cancer.gov]

  • Nausea

    It is also used to prevent nausea and vomiting after surgery. Aprepitant blocks the action of a certain chemical in the brain that may trigger nausea and vomiting. Blocking this chemical may lessen nausea and vomiting. [cancer.gov]

Musculoskeletal

  • Osteoporosis

    Also called Campath. alendronate sodium listen (uh-LEN-droh-nayt SOH-dee-um) A drug used to treat certain bone conditions, such as osteoporosis and Paget disease of the bone. [cancer.gov]

Neurologic

  • Headache

    20% RAEB-1 20% RAEB-2 Associated reticulin fibrosis seen in ˜ 10% of MDS; most are RAEB-F (fibrosis) Age Older individuals, primarily > 50 years of age Presentation Often seek medical attention for symptoms of anemia Fatigue, dyspnea, palpitations, headache [basicmedicalkey.com]

    It can cause headaches, nausea, vomiting, dizziness, confusion, loss of consciousness, and other health problems. acetyl group listen (A-seh-til groop) A small molecule made of two carbon, three hydrogen, and one oxygen atoms. [cancer.gov]

Workup

Serum

  • Erythroblast

    Neutrophil 0.05 Band cell 0.06 Metamyelocyte 0.15 Myelocytes 0.07 Promyelocytes 0.04 Blasts 0.06 Erythroblasts 0.33 Plasma cells 0.01 Lymphocytes 0.11 Monocytes 0.10 Eosinophils 0.01 Basophils 0.01 Other cells 0.00 Bone Marrow Aspirate and Biopsy: The [gpec.ubc.ca]

    An erythroblast with deeply basophilic cytoplasm can be seen in center of image; myeloblasts are smaller, with scant pale cytoplasm. A pseudo-Pelger-Huet cell is also present (center of image). [emedicine.medscape.com]

Treatment

Analyses of EFS From Start of Treatment Treatment regimen was also predictive of outcome. [bloodjournal.org]

S Food and Drug Administration (FDA) on May 2, 2006 for the treatment of patients with myelodysplastic syndromes (MDS) including previously treated and untreated, de novo and secondary MDS of all French-American-British (FAB) subtypes (refractory anemia [medical-dictionary.thefreedictionary.com]

[…] service, product or treatment in your circumstances. [leukaemia.org.au]

Finally, main drawbacks from single-center studies are either the small sample size or intrastudy treatment variations. [doi.org]

Prognosis

Patients with other abnormalities were considered as better prognosis if they did not have an antecedent hematologic disorder (AHD) and as worse prognosis if they had an AHD. [bloodjournal.org]

(Type 2 RAEB), the prognosis is around 10 months survival Proper care should be taken to treat and control complications from MDS. [dovemed.com]

We analyzed these subtypes of RAEB-T in terms of hematological characteristics, karyotype anomalies, and prognosis. [ncbi.nlm.nih.gov]

Back to top Prognosis People with a myelodysplastic syndrome may have questions about their prognosis and survival. Prognosis and survival depend on many factors. [cancer.ca]

Etiology

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

[…] increased blasts or Auer rods 2 categories based on prognosis RAEB-1 2-4% blasts in peripheral blood or 5-9% blasts in bone marrow RAEB-2 5-19% blasts in peripheral blood or 10-19% blasts in bone marrow Auer rods, if present, advance MDS case to RAEB-2 ETIOLOGY [basicmedicalkey.com]

(Etiology) Refractory Anemia with Excess Blasts is caused by genetic mutations. [dovemed.com]

[…] neoplasms; absolute monocytosis (> 1000/mcL [> 1/L]) in blood; significant increase in marrow monocyte precursors Chronic neutrophilic leukemia: Characterized by neutrophilia and absence of the Philadelphia chromosome and the BCR-ABL1 fusion gene The etiology [merckmanuals.com]

Epidemiology

Thrombocytopenia Weakness or feeling tired Diagnostic Exams FISH (flourescence in situ hybridzation) Flow cytometry Immunocytochemistry Immunophenotyping Peripheral blood smear Progression and Transformation ~25% of RAEB-1 and 33% of RAEB-2 transform to AML Epidemiology [seer.cancer.gov]

[…] blasts in bone marrow RAEB-2 5-19% blasts in peripheral blood or 10-19% blasts in bone marrow Auer rods, if present, advance MDS case to RAEB-2 ETIOLOGY/PATHOGENESIS Hematopoietic Stem Cell Disorder Clonal hematopoietic stem cell disorder CLINICAL ISSUES Epidemiology [basicmedicalkey.com]

Epidemiology There are few data on the epidemiology of RAEB, which may account for 20-30% of all MDS cases. MDS is predominantly diagnosed in the elderly population. [atlasgeneticsoncology.org]

Age-related incidence and other epidemiological aspects of myelodysplastic syndromes. Br J Haematol. 1992;82:358-67. INTERNET Besa EC, Woermann UJ. Myelodysplastic Syndrome. Medscape. [rarediseases.org]

Epidemiology and Clinical Features Epidemiology As with other types of myelodysplastic syndromes (MDS), MDS with excess blasts-1 (MDS-EB1) and MDS-EB2 tend to occur in older adults with a male predominance. [emedicine.medscape.com]

Pathophysiology

When patients have neutropenia or thrombocytopenia without excess blasts in the marrow, it is possible that the pathophysiology could be T-cell mediated in patients with MDS that do not have excessive blasts. [businessandleadership.com]

It will nevertheless, be necessary to compare our results to other MDS subgroups to determine whether the decrease of the RBP4 plasma level is related to MDS pathophysiology specific for RAEB-1, or if it is a result of inflammation, as the RBP4 is a negative [link.springer.com]

Prevention

Prevention Although there is a big genetic predisposition to MDS, some risk factors can be avoided to help prevent the disease. These include: Avoiding too much radiation exposure. [syndromespedia.com]

Antibiotics can prevent a simple infection becoming life-threatening. [leukaemia.org.au]

Collaborative overview of randomised trials of antiplatelet therapy, I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. ‏ [books.google.com]

Aloxi listen (uh-LOK-see) A drug used to prevent nausea and vomiting caused by chemotherapy. It is also used to prevent nausea and vomiting after surgery. [cancer.gov]

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