What Are Myelodysplastic Syndromes?

Myelodysplastic syndromes (MDS) are a group of cancers resulting from unhealthy cell production by blood-forming stem cells in the bone marrow. The cells that are produced fail to mature or are abnormally shaped and often die shortly after entering the bloodstream. MDS can potentially affect any of the three major blood-cell types, including red blood cells, white blood cells, and platelets. Complications include anemia, regular infections, and easy bleeding and bruising. In a minority of cases, MDS develops into a fast-growing and dangerous cancer of the bone marrow, known as acute myeloid leukemia. MDS is most common in persons age 65 or older, with men affected more than women.

If you or a loved one is exhibiting MDS symptoms, the oncologists and other caring professionals at Baptist Health can help.

What Are the Symptoms of Myelodysplastic Syndromes?

Symptoms are sometimes slow to manifest with MDS. In time, they might include:

• Labored breathing
• Weakness or fatigue
• Pale coloration resulting from anemia
• Frequent bruising or bleeding
• Regular infections
• Small red spots under the skin, called petechiae.

There are several forms of MDS, depending on which type or types of blood cells are involved. Some of these include:

• Myelodysplastic syndrome with unilineage dysplasia: Blood cell abnormality is limited to one blood cell type. If two or three types are abnormal, this condition is called myelodysplastic syndrome with multilineage dysplasia.
• Myelodysplastic syndrome with isolated del chromosome abnormality: A low red cell count is linked to a particular DNA mutation.
• Myelodysplastic syndrome with ring sideroblasts: Red blood cells develop with too much iron, in deposits called ring sideroblasts.
• Myelodysplastic syndrome with excess blasts: This form affects all three major blood cell types. It also has a tendency to develop into acute myeloid leukemia.
• Myelodysplastic syndrome, unclassifiable: The count for at least one cell type is low, and white blood cells or platelets appear abnormal when viewed under magnification.

What Causes Myelodysplastic Syndromes?

The root source of MDS is the inability of blood-forming stem cells in the bone marrow to produce healthy blood cells in sufficient numbers. Why this happens is not always clear but contributing factors sometimes include:

• Radiation or chemotherapy from a previous cancer treatment
• Blood diseases, including congenital neutropenia and paroxysmal nocturnal hemoglobinuria
• Smoking or tobacco use
• Exposure to the chemical benzene
• Inherited conditions, such as Down syndrome, Fanconi anemia, and Bloom syndrome.

Exposure to heavy metals such as lead and mercury may also play a role.

How Are Myelodysplastic Syndromes Diagnosed?

An MDS cancer is diagnosed in the following manner:

• Physical exam: Your doctor will evaluate your overall health with a thorough examination. He or she will also ask questions about your medical history and possible risk factors.
• Blood test: The blood test will measure a variety of factors present in the blood, including red cells, white cells, platelets, hemoglobin, and other compositional elements. Amounts that are outside of normal parameters are often signals of an underlying medical issue. Additional tests may focus on other substances, such as vitamin B12 and folate.
• Bone marrow aspiration and biopsy: Your physician will remove a small sample of blood, marrow, and bone by inserting a needle into your hip or breastbone. The sample will be analyzed under a microscope for the presence of abnormal cells.

Other forms of analysis may focus on chromosome health or the presence of antibodies in the bone marrow.

How Are Myelodysplastic Syndromes Treated?

Most treatment for MDS is aimed at managing symptoms and slowing the disease’s progress. There are four primary treatment methods employed:

• Blood transfusions: Blood transfusions are a safe and proven means of increasing the volume of healthy red blood cells, white blood cells, and platelets in the body.
• Medications: There are a variety of medications utilized in treating MDS. Growth factors encourage the production of red and white blood cells, lessening the need for regular transfusions. Blood-cell stimulants accelerate the maturation of immature blood cells in the bone marrow. Immunosuppressants help prevent the body from attacking its own blood supply. Antibiotics are also used to treat recurrent infections, due to a decline in the number of effective white blood cells.
• Stem-cell transplant: A more invasive step involves a stem-cell or bone-marrow transplant. Your physician will use chemotherapy to kill off defective stem cells and then replace them with healthy donated ones. Procedures like this come with numerous potential side effects; not every person with MDS is a good candidate for transplantation.
• Active surveillance: Active surveillance is taking a wait-and-see approach to the treatment of MDS. Your condition is monitored but untreated, unless or until a change in symptoms or test results makes clear the best means of addressing your cancer.

Your outlook with MDS will depend on your specific condition, and how likely you are to develop acute myeloid leukemia, which is a serious form of cancer. That said, medical treatment of MDS has shown some success in managing and curtailing symptoms.

Can Myelodysplastic Syndromes be Prevented?

There is no evidence that MDS can be prevented, but there are steps that you can take to lessen your risk. Avoid tobacco use and exposure to radiation, industrial chemicals such as benzene, and heavy metals including mercury and lead. If you develop a myelodysplastic syndrome, reduce the likelihood of infection by frequent handwashing, cleaning food thoroughly before eating, and steering clear of people who have contracted communicable illnesses.

Learn More About Myelodysplastic Syndromes at Baptist Health

Although rare, MDS is a serious condition and potentially fatal. The oncologists and other medical experts at Baptist Health are part of your frontline defense against this form of cancer.