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Why Does A 83 Year Old Having Myelodysplasia Need 2 RBC Transfusions In A Week?
Question: My grandma is 83 years old, she has myelodysplasia. She has normally been getting a RBC transfusion every 2 months. Just recently she went to the hospital and had to get another transfusion in one week exactly she went back to the hospital again and had to get another transfusion... She has been getting procrit shots at her doctors office. Why would she need two RBC transfusions in one week?
Hello and thank you for your question.
Regarding your grandmother and the diagnosis of myelodysplastic syndrome can be something that an elderly person deals with for many years. We understand now as hematologists that the natural course of myelodysplasia is that a patient may require increasing amounts of transfusions over time.
The other thing that we understand about myelodysplasia is that it can progress into what we call a myeloid leukemia.
It may be necessary for your grandmothers physicians to evaluate her bone marrow to see if there is any transition or transformation from the myelodysplasia that she has now to something that is more serious.
As far as why she might need transfusions more than once in a week; she may be getting to the point where the underlying disorder is significantly impacting her bone marrow's ability to produce red blood cells. This is generally a worrisome sign.
I encourage you and I highly recommend that you have your grandmother visit her hematologist for a detailed consultation to discuss the current nature of her disease. There may be some additional medications or other considerations that can be taken at this time.
I thank you again for submitting your question. I remain available if there is anything that you would like to clarify or if you have additional concerns regarding this issue.
Sincerely,
Dr. Galamaga
Regarding your grandmother and the diagnosis of myelodysplastic syndrome can be something that an elderly person deals with for many years. We understand now as hematologists that the natural course of myelodysplasia is that a patient may require increasing amounts of transfusions over time.
The other thing that we understand about myelodysplasia is that it can progress into what we call a myeloid leukemia.
It may be necessary for your grandmothers physicians to evaluate her bone marrow to see if there is any transition or transformation from the myelodysplasia that she has now to something that is more serious.
As far as why she might need transfusions more than once in a week; she may be getting to the point where the underlying disorder is significantly impacting her bone marrow's ability to produce red blood cells. This is generally a worrisome sign.
I encourage you and I highly recommend that you have your grandmother visit her hematologist for a detailed consultation to discuss the current nature of her disease. There may be some additional medications or other considerations that can be taken at this time.
I thank you again for submitting your question. I remain available if there is anything that you would like to clarify or if you have additional concerns regarding this issue.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Prasad
It turns out that she has myelofibrosis not myelodisplasia... We just found out her liver is starting to shut down and her spleen is enlarged... we have been told she is too old for surgeries so thats kinda out and her procrit shots are not working... Are there any possible treatments that she could get to avoid the obvious option hospice till she passes?
Hello again,
Unfortunately there are not any really good treatments for myelofibrosis in this setting. Surgery as you mention can sometimes be an option but with her age and current status - I would also not advocate this approach.
At this point I would advocate a very open discussion with a hospice service in conjunction with her hematologist. Transfusions can continue to a point but the goals of care may need to approach focus on comfort meansures - making sure pain and anxiety are not a concern for her.
I really appreciate that this is a very very difficult situation for you, the family and your grandmother. Along the same lines I wanted to give you concise advice which is real and free of attaching any false hopes. Thanks for your question. If you have any additional concerns I would be happy to address them.
Sincerely,
Dr. Galamaga
Unfortunately there are not any really good treatments for myelofibrosis in this setting. Surgery as you mention can sometimes be an option but with her age and current status - I would also not advocate this approach.
At this point I would advocate a very open discussion with a hospice service in conjunction with her hematologist. Transfusions can continue to a point but the goals of care may need to approach focus on comfort meansures - making sure pain and anxiety are not a concern for her.
I really appreciate that this is a very very difficult situation for you, the family and your grandmother. Along the same lines I wanted to give you concise advice which is real and free of attaching any false hopes. Thanks for your question. If you have any additional concerns I would be happy to address them.
Sincerely,
Dr. Galamaga
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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