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Advancing MDS Nursing – Course 1: The biology, diagnosis and management of MDS
Nurses are an indispensable component to the multidisciplinary team that cares for patients with myelodysplastic syndromes (MDS). As advances in the understanding of MDS expand options for treatment and patient care, it is imperative that healthcare professionals adapt to changes in the clinical landscape.
Designed with nurses in mind, VJAcademy’s Basic introduction to MDS as a disease and management course is a free-access CME accredited e-learning activity, developed in association with the Myelodysplastic Syndromes Foundation.
MDS biology and classification
To support their patients, “It’s really important for nurses to be familiar with the molecular biology of MDS, in order to understand the new and emerging targeted treatments,” explains Cindy Murray, RN, MN, NP-adult, of The Princess Margaret Hospital, Toronto, Canada, in Module 1: Introduction to MDS.
Within the first module, Nurse Practitioner (NP) Murray introduces the pathophysiology of MDS, noting how it transitions to acute myeloid leukemia (AML), and presents the known risk factors for disease development. She also discusses the classification of MDS using both morphology and genetic aberrations.
NP Murray notes: “A typical patient with MDS will be an older adult presenting with symptoms related to underlying cytopenias, such as fatigue, exertional dyspnea, recurrent infections, and unexplained bruising or bleeding. However, many patients are asymptomatic and found incidentally to have abnormal blood counts on routine evaluation.”
Cindy Murray, RN, MN, NP-adult
The Princess Margaret Hospital
Diagnostics and prognostics
Sandra Kurtin, PhD, ANP-C, AOCN
The University of Arizona Cancer Center
In Module 2: Diagnostics and Prognostics in MDS, Sandra Kurtin, PhD, ANP-C, AOCN, of The University of Arizona Cancer Center, Tuscon, AZ, discusses the patient’s journey from presentation to diagnosis. She also examines the available systems for prognosticating patients, highlighting how risk informs the goals of care, and discussing the role of comorbidities, frailty, and transfusion dependence in patient outcomes.
While discussing transfusions, Dr Kurtin emphasizes their importance both as a part of supportive care and as a trigger for the introduction of disease-modifying treatment: “Transfusion dependence is inevitable in the majority of patients with MDS over time… so it is important to understand the impact of transfusion dependence on patients.”
“We know that transfusions are associated with clinical risk, including alloimmunization, transfusion reactions and iron overload. [Transfusion dependence] is a negative prognostic factor for MDS patients… transfusions can provide short term improvement in quality of life but over time lends itself to inferior outcomes,” adds Dr Kurtin.
Treating MDS
In Module 3: Introduction to MDS therapy, Dr Kurtin expands on the patient-centered approach to treatment in MDS, highlighting not only supportive care with red blood cell (RBC) transfusions and iron chelation, but also allogeneic stem cell transplant (alloSCT) as a disease-modifying treatment option.
She explores how risk informs the introduction of therapies, including supportive care, which is offered to all patients to help improve cytopenias and quality of life.
Dr Kurtin also examines the limitations of current therapeutic options: “AlloSCT remains the only curative option for patients with MDS. Most patients, however, are not eligible because they are too old, lack an available donor or have complex comorbidities.”
According to Dr Kurtin, a lack of curative treatments, and many patients being ineligible for the limited number of therapies available, means “there remains an unmet need, and the best way to meet this need is through continuing to enroll people in clinical trials.”
To learn more about the nurse’s role in the management of MDS, explore the other free-access CME accredited activities in this series:
Course 2: The future of treating MDS
Course 3: The role of the nurse in MDS – practical tips for supporting patients and their caregivers
Written by Hannah Balfour
These activities are supported by educational grants from BMS and Taiho Oncology. These supporters have no influence over the production of content.
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