View Single Post
  #6  
Old Sun Oct 21, 2012, 02:57 PM
DanL DanL is offline
Member
 
Join Date: Dec 2010
Location: Denver, CO
Posts: 590
Quote:
Originally Posted by Jen View Post
Dan, do you know the difference with prognosis with MDS trisomy 8? I am being treated with 'supportive' care for now just wondering if I need a second opinion.
RAULD is what the BMB said but there wasn't enough to test for the blasts. New to this. Thx
There is a lot of conflicting literature on the web about trisomy 8 MDS. If it is a sole trisomy 8, then the prognosis is more or less neutral, meaning that it could be an aggressive disease or it could be indolent. I believe that one of the problems with these studies is the inconsistency of reporting and grouping of abnormalities. When trisomy 8 is added in with one or more additional chromosomal abnormalities, it may present a worse clinical outcome.

As Hopeful noted, there are studies done by the NIH that show that trisomy 8may have a strong correlation to auto-immune disorders, so many patients respond quite well to IST such as ATG + cyclosprine and Campath. There are a couple of other factors that may favor use of immune suppression, such as age, length of time since diagnosis, and the presensce of HLA DR15. Another note is that Trisomy 8 also has a high rate of response to Vidaza.

I was diagnosed with trisomy 8 MDS in July 2010 and have not received any supportive care as my RBC, WBC, and Platelets have all been stable, though my platelets teeter around that 20k number. I bruise like nobody's business, but have been fortunate thus far that the platelets I have work well enough.

As for the second opinion, like many others on the forum, I strongly suggest that you reach out to one of the MDS centers of excellence for a second opinion as they may have a different perspective on when to treat and what to treat with, or they may affirm your doctor's current course of action. Either way, it may provide you with more confidence as to which direction is right for you.

I have held appointments with UCLA and the City of Hope in addition to two different hematologists in Denver. For my local hematologist I chose the one who was most closely aligned with the recommendations of the aforementioned institutions.

Sorry for the long response. I think the short answer to your question is that there is good reason that the IPSS and other scoring systems generally list Trisomy 8 as having an intermediate prognosis, but an argument can be made based on your specfic circumstances that it is either more toward the favorable or unfavorable, it just averages out to middle.
__________________
MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
Reply With Quote