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Myelodysplasia

Myelodysplasia, or myelodysplastic syndromes (MDS), refers to a group of diseases that can occur when the blood cells in the bone marrow become abnormal and have problems making new blood cells. The bone marrow cells produce defective blood cells that tend to die earlier than normal cells. Additionally, the body also destroys these abnormal blood cells, leaving an individual without enough normal blood cells. A number of cell types can be affected, but the most common finding in myelodysplastic syndromes is a shortage of red blood cells (anemia)

Myelodysplasia is sometimes an indication that cancer is developing in the body. About 1 in 3 cases of MDS will develop into acute myelogenous leukemia (AML). As a result, MDS is often considered a pre-leukemia condition. Since it can easily go undiagnosed or be improperly diagnosed, the exact number of people diagnosed with myelodysplasia in the United States is unknown. Some estimates have put this number at about 10,000, while other estimate have been as high as 20,000.

What Causes MDS?

Chronic exposures to benzene-containing products like fuels, paints, degreasers and inks have been known to cause cell mutations that can result in leukemia and MDS. Herbicide and pesticide exposures may lead to MDS. Other MDS causes include exposure to cancer treatments, such as chemotherapy and radiation, and exposures to heavy metals, such as lead.

Symptoms of MDS

Myelodysplastic syndromes rarely cause symptoms in the early stages, however in time, myelodysplastic syndromes may cause fever, fatigue, dizziness, shortness of breath, loss of appetite, weight loss, or bone pain. Other signs may include unusual paleness (which occurs due to a low red blood cell count (anemia)), easy or unusual bruising or bleeding (which occurs due to a low blood platelet count (thrombocytopenia)), frequent or severe infections (which occurs due to a low white blood cell count (leukopenia), or pinpoint sized red spots just beneath the skin caused by bleeding (petechiae).

How is MDS Diagnosed?

Since myelodysplasia has a wide variety of symptoms, it must be differentiated from other diseases that cause low blood cell counts. Typically, unusually low cell counts, along with degenerating bone marrow is required for a diagnosis of myelodysplastic syndrome. A variety of tests are available, however, the most common include a complete blood count and chromosomal studies on bone marrow cells.

MDS Treatment Options

Treatment is based on the type of myelodysplastic syndrome. Often more than one type of treatment is used. One of the main goals of treatment is to increase blood counts and limit the side effects and symptoms while preventing the disease’s progression into leukemia. In some cases, treatment might involve blood transfusion, bone marrow transplant, stem cell transplant, blood-cell growth factors, or chemotherapy.

MDS Case Results

$2.75 million Settlement – (California, 1999) – Decedent, a 33-year old male, worked as a carpenter for a subcontractor that was doing construction work at a Mobil Oil Refinery. While working at Mobil’s refinery, decedent was exposed to benzene via contaminated soil. Decedent subsequently died from myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML), both of which are known to be caused by benzene exposure. Plaintiff had a specific chromosomal abnormality tied to previous benzene exposures. Plaintiff filed suit against Mobil for negligence in the maintenance of its premises and a claim was also brought against the environment company charged with monitoring toxic vapor emissions at the refinery.

$7.5 million Verdict – (Nevada, 2011) – From 2002 to 2008, a gasoline tanker truck driver loaded gasoline at the Kinder Morgan Energy Partners terminal between one and seven times a day for deliveries. In 2008, plaintiff was diagnosed with myelodysplastic syndrome (MDS) and died in May 2009 at the age of 58. Plaintiff’s estate sued Kinder Morgan Energy Partners, claiming plaintiff’s myelodysplastic syndrome was caused by exposure to benzene contained in the gasoline at its terminal. Plaintiff made premises liability and product liability claims against Kinder Morgan.

$3,520,000 Verdict – (Iowa, 2016) – In his 30s at the time, decedent was a contracted tanker truck driver who regularly transported pyrolysis gasoline or “DAC”. DAC contains 40% benzene. Plaintiff alleged that through his work, decedent was exposed to benzene during each loading and unloading operation, while hooking and unhooking hoses and from residual benzene vapors. Plaintiff claimed this benzene exposure lead to the decedent’s diagnosis of myelodysplastic syndrome, which quickly developed into acute myeloid leukemia. Decedent died within a year of his diagnosis.

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