Myelodysplastic syndrome Introduction
Myelodysplastic syndrome (MDS) is a group of disorders in which the bone marrow does not make enough healthy blood cells.
MDS is often a precursor to acute myeloid leukemia (AML). In MDS, there are two main types of abnormal blood cell production:
In the bone marrow, stem cells do not develop into normal white blood cells, red blood cells and platelets. This can lead to anemia and other symptoms as your body doesn’t have enough healthy blood cells.
In the bone marrow, immature white blood cells multiply rapidly without maturing into healthy white blood cells that fight infection. These immature white blood cells often crowd out other blood cell types from developing properly.
Both types can cause similar symptoms such as fatigue, shortness of breath and easy bleeding or bruising. Some people may have no symptoms at all while others may have severe symptoms that affect their daily activities and quality of life.
About myelodysplastic syndrome
People with MDS have abnormal blood cells that are unable to carry out their normal functions. Early symptoms may include tiredness, feeling faint, and bruising easily. There are different types of MDS, which may be diagnosed by a doctor based on your symptoms, medical history and the results of tests such as blood tests and bone marrow tests.
The abnormal white blood cells may not function properly and can’t fight infections or help you form new red blood cells and platelets.
MDS can be caused by aging, genetics, exposure to radiation or chemicals, previous treatment for cancer, and certain inherited medical conditions.
Types of myelodysplastic syndromes
There are a number of types of myelodysplastic syndromes (MDS), which are a group of diseases that affect the blood and bone marrow. They’re also known as myeloproliferative neoplasms (MPN), which means they can cause the bone marrow to produce too many white blood cells.
MDS can be divided into four main types:
- acute myelogenous leukemia (AML)
- chronic myelogenous leukemia (CML)
- acute promyelocytic leukemia (APL)
- essential thrombocythemia
Symptoms of myelodysplastic syndrome
The symptoms of myelodysplastic syndrome can vary widely from person to person, and some people may not have any symptoms at all.
Symptoms of myelodysplastic syndrome include:
- Feeling tired even after a good night’s sleep
- Easy bleeding or bruising
- Unexplained weight loss
- Unexplained fever
- Shortness of breath with mild activity (such as walking up stairs)
- Bone pain (typically in the ribs and back)
- Pain or tenderness in your abdomen (belly) when you press on it
When to see a doctor?
There are no standard guidelines for when to see a doctor if you have MDS. That’s because it depends on the type of MDS you have, how serious it is and how well your body is handling it.
If you have MDS and have symptoms like shortness of breath or easy bruising, see your doctor. Your doctor will ask about your medical history and perform a physical examination. He or she may order some tests to learn more about the condition and its severity.
If you already know that you have a specific type of MDS, such as refractory anemia with excess blasts (RAEB) or
chronic myelomonocytic leukemia (CMML), then talk to your doctor about whether your condition is stable or if it’s likely to progress. If it’s stable, then follow-up visits with your doctor should be yearly or every other year depending on the type of MDS.
Causes related to Myelodysplastic syndrome
Infections may trigger or worsen myelodysplastic syndromes in some people. Infections most often associated with myelodysplastic syndromes include Epstein-Barr virus (EBV), cytomegalovirus (CMV), and chronic hepatitis C infection.
Treatment for these infections usually improves symptoms and reduces complications from the underlying condition.
Risk factors for Myelodysplastic syndrome
Age: MDS is most often diagnosed in people between the ages of 60 and 80. Men are more likely than women to develop the disease.
Ethnicity: The condition is more common in people of African-American, Asian or Hispanic descent.
Chronic kidney disease: MDS is more likely to occur in people with chronic kidney disease (CKD). People who have CKD and are not receiving dialysis are at higher risk of developing MDS or acute myeloid leukemia (AML).
Chronic obstructive pulmonary disease (COPD): People with COPD and asthma may be at increased risk of developing MDS or AML.
Treatments for Myelodysplastic syndrome
Treatment for MDS depends on how advanced the disease is and whether or not it has spread beyond the bone marrow into other organs or tissues. Some people with MDS may be able to manage their symptoms without treatment and live for many years. Others may be given treatments to help relieve their symptoms and improve their quality of life.
Types of treatment include:
Chemotherapy: Chemotherapy uses drugs to kill cancer cells or stop them from growing and dividing. It’s usually given in cycles over several weeks or months.
Targeted therapy: Targeted therapy uses drugs to target specific characteristics of cancer cells so they can be killed off more easily. It may work on its own or be used alongside chemotherapy.
Are there any complications related to Myelodysplastic syndrome?
There are a number of complications that may occur with myelodysplastic syndrome. Complications are more common in people with advanced disease, who often have anemia (low red blood cell count), low white blood cell count and low platelet (blood cells that help clot) count.
The following are the most common complications:
Anemia – This occurs when there are not enough red blood cells in your body to carry oxygen to all of your tissues. Anemia can cause shortness of breath, fatigue, weakness and other symptoms. Anemia is treated by transfusing red blood cells or receiving a bone marrow transplant from another person.
Bleeding – Bleeding can occur from cuts or wounds, nosebleeds or bleeding inside the body, such as gastrointestinal (GI) tract bleeding or hematemesis (vomiting up blood). To prevent bleeding, avoid aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and other medications that can increase the risk of bleeding. Ask your doctor how long you should avoid aspirin before surgery.
Low platelets – Platelets help form clots in your blood; when there are too few platelets in your body, it increases your risk of bleeding even more than anemia.
Conclusion
Myelodysplastic syndrome (MDS) is a heterogeneous disease that occurs when the bone marrow does not produce enough healthy blood cells.
It can be caused by bone marrow damage, exposure to certain chemicals or drugs, or genetic conditions. It is also associated with a higher risk of developing other hematologic malignancies such as acute myeloid leukemia (AML).
The diagnosis of MDS is based on the presence of abnormal blood cell counts and/or blood smear examination results. The prognosis of MDS depends on its subtype and stage at presentation and may vary dramatically from one patient to another. Some patients experience only mild anemia while others develop severe cytopenias requiring blood transfusions or platelet transfusions. The most common cause of death among patients with MDS is infection due to neutropenia (low white blood cell count), which can lead to sepsis (bloodstream infection).
