What Is Myelodysplastic Syndrome (MDS)?

Myelodysplastic syndrome, or MDS, is a group of bone marrow disorders that can lead to bone marrow failure and other serious health problems. It’s sometimes called preleukemia because it can develop into acute myeloid leukemia (AML).

The blood cells in people with MDS aren’t normal. There’s a problem with their DNA. They’re not making enough healthy blood cells, and they have too many immature blood cells. As a result, people with MDS are at risk for infections and bleeding.

MDS is usually diagnosed after a person has been having symptoms for some time. But the symptoms can vary from mild to severe, depending on what type of MDS you have.

Who Gets Myelodysplastic Syndrome?

MDS most often affects people older than 60 years old, although younger people can develop it as well. It’s rare in children and teens but more common among African Americans than Caucasians (whites).

Therapy-Related Myelodysplastic Syndrome and Preleukemia?

Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, and they encompass a number of conditions ranging from the benign refractory anemia (RA) to the more severe refractory anemia with ringed sideroblasts (RARS) or acute myeloid leukemia (AML). MDS is a heterogeneous disorder, which can affect patients of all ages and occurs in approximately 1% of all adults.

Therapy-related MDS/preleukemia is a subtype of MDS that occurs after exposure to alkylating agents such as cyclophosphamide, melphalan, busulfan, and chlorambucil. The incidence of therapy-related MDS has been estimated at 2% among cancer patients who received alkylating agents. The median time from initiation of chemotherapy to diagnosis was 5 years; however, the mean age at diagnosis was 72 years, with most cases occurring in patients over 60 years old.

The symptoms of t-MDS vary depending on the stage of the disease. In its early stages, t-MDS may not have any symptoms at all. But as it worsens, you may start having issues with your blood cell production and anemia (low red blood cell count). Other symptoms include fatigue (feeling tired), shortness of breath upon exertion, dizziness, and easy bruising or bleeding.

How Myelodysplastic Syndrome Develops?

In MDS, immature blood cells called myeloblasts accumulate in the bone marrow. This causes the marrow to be replaced with myeloblasts. As more immature blood cells are produced, normal blood cells become fewer and fewer.

The stages of MDS are classified according to the percentage of immature myeloblasts in your bone marrow:

Stage 1: less than 20 percent

Stage 2: 20-34 percent

Stage 3: 35-50 percent

Stage 4: greater than 50 percent

How to treat Myelodysplastic Syndrome?

The goal of treatment is to improve quality of life and avoid complications. Treatment may include:

Blood transfusions. Blood transfusions are used to treat anemia, which can occur in people with myelodysplastic syndrome. During a transfusion, blood is removed from one person and given to another. Blood transfusions are often done on an outpatient basis or right before a planned surgery. A blood transfusion may be given if your doctor thinks you have too little red blood cells (anemia). It may also be given if you need to prevent serious complications from low red blood cell counts, such as bleeding into the skin and brain.

Chemotherapy (chemo). Chemotherapy drugs are used to kill cancer cells and shrink tumors. The most common types of chemo drugs used for myelodysplastic syndrome are fludarabine, cladribine, pentostatin, and azacitidine (Vidaza). These drugs usually make people more tired than other types of chemo drugs do. They can also cause vomiting and mouth sores, hair loss, diarrhea, fever and chills. Patients who receive these drugs must stay in the hospital while they’re being given them so that their doctors can watch for any side effects.

How can you acquire Myelodysplastic Syndrome?

You inherit the disease from your parents. If you have MDS and one of your parents has MDS, there’s a 50 percent chance that you will have it too.

You may be exposed to some kind of environmental toxin or radiation. This is not common, but it is possible.

You may develop an infection that suppresses your immune system and allows MDS cells to grow unchecked. This is also not common but has been seen in people with AIDS or who have received chemotherapy treatments for other types of cancer.