Myelodysplastic Syndromes (MDS)

Definition

Myelodysplastic syndromes (MDS) are a group of diseases that involve dysfunction of the bone marrow. Bone marrow is the tissue found within the bones; its task is to create mature blood cells from stem cells. In all forms of MDS, this normal cell-creation process is disrupted by the overproduction of clones of a single stem cell. This leads to a decrease in production of normal red blood cells, white blood cells, and platelets.

There are five types of MDS. Some forms are more serious than others; all of them are serious enough to require a physician’s care. Thirty percent of people with MDS develop acute myeloid leukemia (AML). Leukemia is a cancer of the white blood cells and their parent cells. Many blood disease experts consider MDS to be a type of cancer.

Location of Active Bone Marrow in an Adult

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Causes

The cause of MDS is unknown, but research shows that certain risk factors are associated with the disease.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors are associated with a higher risk for developing MDS:

• Family members with MDS or Fanconi anemia (Fanconi anemia is a rare type of anemia )
• Age: 60 or older
• Sex: male
• Congenital conditions: individuals with Down Syndrome have a higher risk
• Exposure to large amounts of radiation
• Exposure to certain chemicals, such as benzene
• Exposure to pesticides
• Radiation therapy and/or chemotherapy treatment for cancer
• Smoking

Symptoms

• Typically, there are no symptoms in the early stages of MDS. Later stage symptoms may vary from person to person, depending on how serious the disease is. Later stage symptoms may include:
• Signs of anemia due to underproduction or red blood cells include:
  • Fatigue
  • Shortness of breath
  • Pale skin
  • Feeling weak and tired
  • Congestive heart failure (in severe cases)
• Neutropenia occurs when there are inadequate levels of white blood cells. White blood cells fight infection. Signs of this condition include:
  • Fever
  • Cough
  • Frequent, unusual, or especially serious infections
• Thrombocytopenia occurs when there are inadequate levels of platelets in the blood. Platelets stop bleeding by clotting the blood. Signs of thrombocytopenia include:
  • Bleeding easily, especially from the nose and gums
  • Bruising easily

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. The symptoms for MDS can indicate many other conditions. Doctors have to rule out other conditions before diagnosing MDS.

Tests may include the following:

• Blood test to check your red and white blood cell counts and platelet counts and to check how the blood cells look.
• Bone marrow biopsy to check for MDS. A bone marrow biopsy is the removal of a sample of bone marrow for testing.
• Your doctor may also order other tests to rule out other conditions.

Treatment

Treatment for MDS depends on your age, other medical conditions, and how serious the disease is. Treatment also depends on how far along the disease has progressed to AML. Often, treatment includes relieving the symptoms of MDS. Talk with your doctor about the best treatment plan for you. You may be referred to a hematologist and an oncologist. A hematologist specializes in blood diseases. An oncologist specializes in cancer. Treatment options include:

Prevention

To help reduce your chances of getting MDS, take the following steps:

• Avoid exposure to hazardous chemicals such as benzene
• Don’t smoke or if you do smoke, quit
• Reduce your risk for developing cancer:
  • Eat a balanced, healthful diet.
  • Stay active.
  • Maintain a healthy weight.
  • Avoid environmental and occupational risks.