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Myelodysplastic syndromes (MDS) are neoplastic lesions of hematopoietic stem cell Cells with one or more lineages of pathological hematopoiesis, ineffective hematopoiesis and high risk of transformation to acute leukemia.
Due to the abnormal development of megakaryocytes in patients with MDS, or the inhibition or destruction of megakaryocytes, the platelet function is abnormal, and the platelet count is low. In the case of severe reduction, platelets are less than 20, and different degrees of bleeding are prone to occur.
span>Myelodysplastic syndrome platelets can’t increase, what should I do?
First, supportive maintenance therapy
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In the case of serious decrease in platelet count, emergency treatment is required in order to avoid danger. Especially in MDS patients with platelet counts in single digits, the risk of internal bleeding is high, and it needs to be improved to a safe level as soon as possible. scope. Including: platelet transfusion, blood transfusion, application of recombinant human thrombopoietin and other treatment methods.
then, Avoid taking drugs that affect platelet function
Mainly including some anti-platelet aggregation drugs, the common ones are: ①, aspirin, which It can irreversibly inhibit the activity of platelet cyclooxygenase, thereby inhibiting the activation, aggregation and release of platelets. ②, dipyridamole or dipyridamole, reversible inhibition of platelet phosphodiesterase, so that platelet cyclic adenosine monophosphate is not easily decomposed and increased, resulting in inhibition of platelet aggregation and release reaction. ③, Ticlopidine, by blocking the platelet aggregation reaction induced by adenosine diphosphate, etc., activates platelet adenosyl cyclase, is a specific antiplatelet drug.
MDS is not equal to leukemia, but the risk and degree of malignancy are not inferior at all in acute leukemia. In this regard, it is emphasized that for patients with severe myelosuppression (including severe thrombocytopenia), in addition to supportive maintenance therapy, the main cause of blood cell suppression should also be identified:
For example: myelosuppression caused by chemotherapeutic drugs, or the bone marrow image has not been relieved during the treatment of the disease, or the disease has further developed, and whether there is a positive platelet antinuclear antibody, etc., and then target the specific cause. Take an appropriate treatment plan.
Beijing-Shanghai-Luzhou Hematology Association Clinic
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