Myelodysplastic Syndrome Facts

A couple of decades ago, medicine looked at Myelodysplastic Syndrome (MDS) as being "pre-leukemia."

Consequently, patients were not treated when they were diagnosed with MDS; instead they were often observed, and their doctors waited until MDS developed into acute myeloid leukemia (AML). Part of this was because there were treatment options for AML, and there weren't any for MDS.

The estimate for the number of new cases of MDS in the United States annually is between 13,000 and 15,000.

What Happens in MDS

Today, more is understood about MDS. For example:

• -- Fundamentally, MDS is a failure of the bone marrow. Patients have a 'cytopenia', meaning they have either a low white blood cell count, they are anemic, or they have a low platelet count. They may have a combination of these.
• -- During the process of hematopoiesis—the formation of blood cells in the bone marrow—something becomes altered, so that blood cell formation is lacking. Perhaps white blood cells aren't forming properly, or red blood cells, or platelets, or a combination of them. This is where the bone marrow is failing. For some patients, MDS remains here and doesn't progress. The patient might have a compromised immune system, they may be anemic, they may bleed easily, but the cells in question have not transformed into leukemic cells. The opposite, in fact: as damaged, non-functioning blood cells, they have a tendency to die sooner than other cells.
• -- MDS does however sometimes transform into AML. According to the American Cancer Society, approximately one in three MDS cases will transform into AML.

Risk Factors for MDS

MDS is a rare disease, but its risk factors are becoming better understood.

• -- Being age 60 or older
• -- A history of chemotherapy treatment
• -- A history of radiation treatment
• -- Exposure to chemicals or other carcinogenic materials

Symptoms of MDS

It is uncommon for MDS to cause early symptoms that might alarm a person to be seen by a physician. However, a routine blood test can often raise the red flag for doctors to explore further and eventually make a diagnosis of MDS.

Otherwise, some symptoms can include the following, which are all the result of one or more of the blood cells produced in the bone marrow coming up short:

• -- Fatigue or shortness of breath
• -- Pale skin (paler than usual)
• -- Easy to bruise or bleed
• -- Pinpoint spots under the skin caused by bleeding
• -- Frequent fever or infections

Treating MDS

Since MDS is a group of diseases, treatment will vary depending on the precise nature of the patient's form of MDS. Treatment will typically be based on type, coupled with the age and the health of the patient. Otherwise, treatment might include:

• -- Chemotherapy (hypomethylating drugs)
• -- Immunotherapy
• -- Growth factors
• -- Supportive therapy
• -- Stem cell transplantation (rare, since many people over age 60 are not considered good candidates for transplant)

The two drugs most frequently used to treat MDS are decitabine (Dacogen) and azacitidine (Vidaza). Neither is especially effective in the majority of patients.

SOURCES:
MedlinePlus
American Cancer Society
MD Anderson Cancer Center