By: Mary Brolley, MD Anderson Staff Writer
He had no symptoms. But he fit the profile.
Jerry Reidy of Aurora, Colo., went in for a routine cholesterol check in late summer 2008. When the results came back, his family doctor gave him a call.
"He said it looked like I was anemic, but he wanted to do more tests."
After the tests -- again with suspicious results -- the doctor sent Reidy to an oncologist, who did a bone marrow biopsy. The biopsy indicated that Reidy had myelodysplastic syndrome, one of a diverse collection of blood disorders formerly called pre-leukemia.
MDS diagnoses increasing
Myelodysplastic syndromes share a single, defining trait: the bone marrow is damaged and doesn't produce enough blood cells. Incidence of this condition is on the rise, perhaps due to physicians' growing awareness of the disease and improved diagnostic procedures.
The National Hematologic Diseases Information Service estimates that 7,000 to 12,000 people, mostly older adults, develop MDS every year. In about 30% of cases, MDS turns into leukemia. Even when it doesn't, the syndromes pose serious threats to health.
To worry or not to worry?
"At first I wasn't too worried," Reidy says. "I didn't have any symptoms, so I thought it was like being anemic. Then I started reading about it. I thought, 'This is kind of serious.'
I asked my local oncologist what we should do about it. He said we'd wait and watch, and do transfusions if and when I needed them. But I wasn't comfortable with that."
Reidy's brother was aware of MD Anderson, one of the largest referral centers for MDS in the United States. Reidy soon had an appointment with Guillermo Garcia-Manero, M.D., professor and chief of the Section of Myelodysplastic Syndromes in the Department of Leukemia.
Clinical trial offers hope
"At my first appointment, Dr. Manero showed me the tables that said I had about 22 months to live. But then he said, 'There's a protocol I think you should try. It could extend your life by five years.'"
"I'm not as dumb as I look. I said, 'I'll try that.' "
He went home, got some clothes, then came back and lived in an apartment in Houston for a two-month treatment process. His wife and family visited him as often as they could.
He had a combination of injections and a liquid form of Vidaza®,a hypomethylating agent.
Hypomethylating agents cause rapidly dividing cells to die while leaving non-proliferating cells alone. These agents and others, like lenalidomide, are among the most promising drugs available to treat MDS.
Other options, risks
Another option for certain patients is a stem cell transplant, a treatment in which chemotherapy is followed by the replacement of blood-forming cells from a matched donor. For more information on these therapies, see the link to the related story below.
Garcia-Manero says the typical patient diagnosed with MDS is an older male with exposure to chemicals. Cancer survivors treated with chemotherapy or radiation are also at risk.
Smoking seems to increase the risk of developing the disease.
Reidy's history tracks well with this description. "I smoked for 20 years, though I quit 40 years ago," he says. "And because I ran a metal refinishing business, I had my hands in lacquer thinners for 40 years."
'The poster boy for MDS'
Over the months of treatment in the Leukemia Center, Reidy developed a friendly rivalry with an MDS patient from Arkansas.
"I met him in the waiting room. He was shooting off his mouth," Reidy jokes. "I told him I would be the poster boy for beating MDS."
"This guy said 'no,' he would be. We went back and forth."
"So I made a big poster of me playing in a softball tournament. The headline said, "Ha, ha, take that, MDS!'"
Because he's still in the Phase I clinical trial, Reidy returns to MD Anderson monthly for tests and a visit with Garcia-Manero and his staff. If his blood levels are acceptable, he then goes home to begin another cycle of taking Vidaza® in pill form for seven days, then is off for 21 days.
His side effects have been mild -- a sporadic rash and occasional constipation or diarrhea after taking the pills -- and he hasn't needed a transfusion since diagnosis.
Wiry and energetic, Reidy still works in the family metal refinishing business, plays softball frequently and exercises with a trainer twice a week. He is grateful that the clinical trial is going so well.
"The last time I went in for a check-up, Dr. Manero looked at my chart and said, 'How are you feeling?'
"Then he looked at me and said, 'Why do I ask? You look like a million bucks.'"
Q&A: Focus on Myelodysplastic Syndromes
A growing incidence of myelodysplastic syndromes, mostly in older adults, has sent researchers and clinicians scrambling for answers to the biology and treatment of this group of serious blood disorders.
MD Anderson resources:
Treatment advances in myelodysplastic syndromes (Leukemia Insights)
Leukemia Center at MD Anderson
Guillermo Garcia-Manero, M.D.
Myelodysplastic syndromes treatment (ACS)
MDS Patient 'Looks Like a Million Bucks'
By: Mary Brolley, MD Anderson Staff Writer
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