Myelodysplastic Syndrome (MDS)

Myelodysplastic Syndrome (MDS)

What is MDS?

Myelodysplastic Syndromes (MDS) are a group of diverse bone marrow disorders in which the bone marrow does not produce enough healthy blood cells. Therefore, Myelodysplastic Syndrome is often referred to as a “bone marrow failure disorder”.

In healthy people, the bone marrow functions as a factory that manufactures three kinds of blood cells: red blood cells, white blood cells, and platelets. Healthy bone marrow produces immature blood cells – called stem cells, that normally develop into red blood cells, white blood cells, and platelets. In myelodysplastic syndrome, these stem cells may not mature, or they may have a shortened life span, resulting in fewer than normal blood cells in circulation. Due to this, patients with myelodysplastic syndrome often suffer from anemia (low blood cell counts) and may require red blood cell transfusions.

There are three main types of MDS depending on which type of blood cells are involved:

  • refractory anaemia – where you don't have enough red blood cells
  • refractory cytopenia – where you don't have enough red blood cells, white blood cells or platelets
  • refractory anaemia with excess blasts – where you don't have enough red blood cells, white blood cells or platelets, and have a higher risk of developing AML (Acute Myeloid Leukemia)

The disease level can be categorized based on the risk level of disease progression into Myeloid Acute Leukemia (AML).

Therefore, MDS can be categorized into 5 risk levels:

  • very low
  • low
  • intermediate
  • high
  • very high risk

MDS, also known as myelodysplasia, can affect people of any age but is most common in adults over the age of 60.

 

What are the symptoms?

In the early stages, patients generally experience very few symptoms or none. In time, MDS may cause:

  • Fatigue, weakness
  • Shortness of breath
  • Paleness (pallor), due to anemia
  • Frequent infections (due to low white cells count)
  • Easy bruising, bleeding (nosebleeds)

Some people only discover they have MDS after blood tests. If you experience any of these symptoms, or you suspect you may have MDS, contact your doctor to run some tests.

 

Diagnosis

MDS is difficult to diagnose but it is generally done by carrying out blood tests (Complete Blood Counts (CBC)) and bone marrow tests. The blood test shows whether the patient displays blood cell types within normal ranges. This is a routine test, performed before surgery or as a regular checkup by your doctor. If the test presents abnormal levels of red blood cells, platelets, or white blood cells, it can be a first sign of MDS.

In case the blood test does not show another reason for the abnormal blood counts, your doctor will perform bone marrow tests to procure samples from your bone marrow. One type of sample is called ‘bone marrow biopsy’ where the doctor takes a sample of your bone marrow. The second sample is called ‘bone marrow aspirate’ where your doctor will draw out liquid from the bone marrow space. These tests are performed under local anesthesia.

 

Treatments

All treatments for MDS currently in use help with side effects or to slow down the disease progression. However, MDS can sometimes be cured with stem cell transplants or intensive chemotherapy. The type of treatment administered depends on what type of MDS you suffer from, the risk level, and your health condition.

The following treatments are given to keep the symptoms under control:

  • Blood transfusions (for anemia)
  • Antibiotics (to treat infections)
  • Injections of growth factor medicines, such as erythropoietin or G-CSF
  • Medicine to get rid of the excess iron in your blood

Other treatments include:

  • Immunosuppressants
  • Chemotherapy (for high-risk MDS)
  • Stem cell transplant

 

In case you suffer from anemia due to MDS and would like to participate in a clinical trial that may help alleviate your symptoms, read about a current research study on MDS here.

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