Thrombocytopenia in myelodysplastic syndrome

Česká verzia

Authors: J. Čermák
Authors place of work: Ústav hematologie a krevní transfuze Praha, ředitel prof. MUDr. Marek Trněný, CSc.
Published in the journal: Vnitř Lék 2010; 56(Supplementum 1): 39-42
Category: 16th Parizek's Days, Ostrava-Poruba, March 25th –26th 2010

Summary

Thrombocytopenia occurs at the time of diagnosis in approximately 30 % of patients with myelodysplastic syndrome (MDS) and may lead to serious complications in patients with both early and advanced disease. Multilineage dysplasia itself represents an adverse prognostic factor in MDS. A dysregulation of thrombopoiesis resulting in ineffective platelet production and increased apoptotic rate of platelets is the most common reason of thrombocytopenia in MDS patients, an absolute decrease in platelet production represents a less frequent reason of low platelet counts. Treatment approaches to thrombocytopenia include administration of donor platelet concentrates, immune suppression, stem cell transplantation in selected patients and recently administration of thrombopoietin agonists. An effective and relatively safe treatment of thrombocytopenia with thrombopoetin agonists might replace in patients with early MDS indication of potentially more hazardous treatment approaches as immune suppression or stem cell transplantation.

Key words:
myelodysplasia – thrombocytopenia – pathogenesis – treatment – immune supression – romiplostim

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