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Myelodysplasia

Selina M. Luger, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
My Mom was diagnosed with Myelodysplasia. Mom has been on various forms of medication to encourage her bone marrow into producing red blood cells. So far nothing has worked. Mom's hematologist is now putting her on Rituxan. Please explain why?  
Thank you.

Selina M. Luger, MD, Director of the Leukemia Program and Assistant Professor of Medicine at the University of Pennsylvania, responds:

Myelodysplasia is a disorder in which the bone marrow cells do not work properly and often look funny as well. As a result, the bone marrow cells do not mature properly, resulting in an inadequate number of red blood cells, white blood cells or platelets or a combination of all three. There are several options in the treatment of myelodysplasia:

• transfusions alone
• replacing the cells the bone marrow is not making
• bone marrow transplant, a very aggressive and risky treatment which is really only appropriate in young patients with this disorder.

Otherwise, doctors try and give medicines that they think might have a chance of encouraging the bone marrow cells to produce more normal blood cells and therefore decreasing the need for transfusions. Clinical trials are underway. There is no standard therapy for myelodysplasia. Different agents have been used with variable success rates in terms of decreasing the need for transfusions. I have not heard of using Rituxan for this purpose. It may be worth asking your mother's physician why he/she has chosen this agent.