About Myelodysplastic Syndromes
The termmyelodysplastic syndromes (MDS) is used to describe a broad range of chronic bone marrow cancers that gradually reduces the body's ability to produce red blood cells, white blood cells, and platelets. This can lead to a variety of problems that can be readily diagnosed by routine blood tests such as:
- Anemia - abnormally low numbers of red blood cells that develops in up to 85% of patients with MDS.
- Thrombocytopenia - abnormally low number of platelets that occurs in about 30% to 45% of MDS patients.
- Neutropenia - abnormally low numbers of white blood cells can be found in up to 40% of MDS cases.
People with myelodysplastic syndromes have a risk of the disease progressing to acute myeloid leukemia (AML), which is a bone marrow malignancy. Some studies suggest that AML is a natural progression of MDS and not a separate disease. In some people, MDS may gradually progress over a period of many years while in others it progresses rapidly to AML.
The risk of myelodysplastic syndromes increases with age as the disease commonly affects older people between the ages of 58 and 75. About 85% of all patients diagnosed with MDS are older than 60 years. The disease is rarely observed in young adults.
In general, MDS is divided into the following two broad categories:
- Primary or idiopathic MDS - represents about 90% of all MDS cases that results from age-related injury to hemopoietic (blood-forming) stem cells.
- Secondary or therapy-related MDS - represents up to 15% of cases and is the result of cancer-related chemotherapy or radiation therapy.
The exact causes of MDS remains unknown, however, certain genetic mutations have been linked to the development of MDS. MDS has also been linked to certain environmental factors such as:
- Radiation or chemotherapy
- Smoking
- Pesticides
- Organic chemicals and solvents
- Heavy metals
Patients with myelodysplastic syndromes most commonly seek medical attention because of symptoms such as fatigue or shortness of breath, which result from underlying anemia caused by MDS. It has been estimated that about 85% of patients with MDS experience anemia.
Neutropenia and thrombocytopenia typically occur in patients in the more advanced stages of MDS. Patients with neutropenia are more susceptible to infections, while those with thrombocytopenia may experience bleeding and clotting problems.
A variety of tests and procedures may be used in the diagnostic evaluation of people with suspected MDS. These include:
- A detailed patient history, including signs/symptoms and risk factors for MDS.
- A thorough physical examination to determine the patient's overall health status and to look for signs/symptoms of MDS.
- A sample of blood is withdrawn to measure the levels of various blood components.
- Peripheral blood smear - A test where the blood is examined under a microscope to determine the type, shape, and size of the blood cells in order to detect any abnormalities.
- Bone marrow aspiration and biopsy - A hollow needle is inserted into either the hip bone or the breast bone and bone marrow, blood, and a small piece of bone is removed and is examined under a microscope for the presence of any abnormal cells.
- Cytogenetic analysis - A sample of blood and bone marrow are examined under a microscope to look for any chromosomal abnormalities.
Treatment of MDS is tailored for each patient taking into consideration factors such as the severity of the low blood counts, the risk of progression to AML, other potential complications, and the patients age and overall health. The goals of treatment of MDS include:
- Prevent and/or treat complications of MDS
- Attempt to cure MDS, if possible
- Maintain the highest possible quality of life
- Prolong survival
The treatment options for myelodysplastic syndromes are based upon the age of the patient, clinical test results, and the patient's prognosis. There are three main treatment approaches that may be considered:
One approach involves providing only supportive treatment to control symptoms such as anemia, thrombocytopenia and neutropenia. With this approach, however, there is no intent to cure the underlying cause of the disease.
Another approach is to stimulate normal hematopoiesis - the production of red blood cells, white blood cells, and platelets.
The third approach is to eradicate the myelodysplastic clone to restore normal hematopoiesis.
The Medifocus Guidebook on Myelodysplastic Syndromes is a unique, comprehensive patient education resource that contains vital information about Myelodysplastic Syndromes that you won't find anywhere else in a single resource. The Guidebook will answer many of your questions about this condition that your healthcare provider may not have the time to answer. To learn more about the Guidebook, please click here
