What IS Myelodysplastic Syndrome?

Myelodysplastic syndromes or MDS are a group of disorders where a person’s bone marrow does not produce enough healthy blood cells. It is also referred to as the bone marrow failure disorder and is a type of cancer. Tom Seymour explains more about MDS in his article that was reviewed by Yamini Ranchod, Ph.D., MS.

Some of the blood-forming cells in the bone marrow damages that come from MDS lead to low numbers of one or more types of blood cells. Currently, about 13,000 are diagnosed with MDS in the US each and every year, and most are diagnosed at aged 65 years or older. Outlook will vary for those with MDS and in his article, he looked at how prognosis is made and what the outlook may be for individuals diagnosed with this condition.

Once diagnosed the person’s doctor will give an educated guess of the likely course of the disease and how long the person can survive. Each prognosis is unique, which makes the prognosis difficult as well as the progression of the disease. MDS is identified by testing the individual’s blood and bone marrow. Some types are refractory cytopenia with unilinear dysplasia, refractory anemia with ringed sideroblasts, refractory cytopenia with multilineage dysplasia, refractory anemia with excess blasts, myelodysplastic syndrome and myelodysplastic syndrome associated with an isolated del chromosome abnormality.

The International Prognostic Scoring System (IPSS) is the most common system used and looks at three different values, such as the number of low blood counts the individual has, the percentage of young white blood cells, known as blasts, in the bone marrow cells and the number of abnormal gene changes in the bone marrow cells.
A more recent scoring system known as the WHO Prognostic Scoring System (WPSS) is based on the type of MDS based on the WHO classification, the chromosome abnormalities and whether the individual needs a blood transfusion or not.

The exact causes of MDS are unknown. The risk factors do not necessarily mean a person will develop the disease and some acquire MDS without any of the risk factors. Chemo is the most important risk factor of MDS and is called secondary MDS following chemotherapy. Radiation Therapy also increases the risk of MDS. Those having chemo or radiation therapy are at risk of developing MDS for up to 10 years afterward.

The American Cancer Society states that those with certain inherited syndromes appear to be more at risk of MDS, such as Fanconi anemia, Scwachman-Diamond syndrome, Diamond Blackfan anemia, familial platelet disorder, and severe congenital neutropenia.

Certain chemicals and exposure to radiation have been linked to MDS, Other risks are smoking, age and gender and is more common in men. Life expectancy is rated by low, int-1, Int-2 and high. These range from months to 5.7 years of life expectancy. A third of those with MDS will see their condition progress into acute myeloid leukemia (AML) and is sometimes referred to as pre-leukemia.

Treatment may include supportive treatment, immunosuppressant treatment, chemotherapy or bone marrow transplant and rarely cured. The best a person can do is choose healthy lifestyles such as giving up smoking, cut down alcohol intake, follow a healthy diet, get enough exercise and keep stress levels under control.

Dr Fredda Branyon