Peripheral circulation in patients with myelodysplasia

Patients with myelodysplasia have increased wound dehiscence and ulcer formation compared with the normal population. While neurologic deficits and resultant muscle imbalance are the presumed etiologies for these complications, no study has investigated the role of peripheral circulation in myelodysplasia. Eighty-two patients (ages 2-20) were prospectively recruited for this study, consisting of 41 patients with myelodysplasia and 41 age-matched controls. Peripheral circulation was quantified using systolic blood pressures in arms and legs (ankle-brachial index [ABI]) and transcutaneous pO2 measurements (TcO2) in a standardized location in the forefoot. Both groups had similar mean age. Patients with myelodysplasia had a lower ABI but similar TcO2 compared with the control group. Among the patients with myelodysplasia, the ABI and TcO2 did not vary according to the level of neurologic deficit or the patient's age. However, those with prior surgical procedures had significantly higher ABI and TcO2 compared with those without prior surgery (P < 0.05). This study suggests that patients with myelodysplasia may have decreased peripheral circulation compared with normal controls. Vascular insufficiency may therefore contribute to increased wound healing complications and ulcer formation in these patients.