Myelodysplastic Syndrome

Myelodysplastic syndrome or MDS pertains to a group of blood disorders resulting from the abnormal production of blood cells in the bone marrow.  Sometimes also called bone marrow disorders, it is characterized by the imbalance of healthy blood cells in the body.  Persons affected by this condition suffer from fatigue, bruising, bleeding and are more prone to infections.  Though MDS is not cancer, it may develop into acute myeloid leukemia.  This is why it is also referred to as preleukemia.

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About Myelodysplastic Syndrome

The bone marrow is responsible for the production of blood cells.  In normal cases, it produces the right quantity, shape, size and function of the red blood cells, white blood cells and platelets.  But in the case of MDS, the bone marrow is unable to produce healthy blood cells.  In most MDS, the bone marrow is hyperactive, producing more blood cells than normal, but these are immature and cannot function properly.  They die before or immediately after entering the blood stream, thus resulting in low blood cell quantity.

Causes

Though the root cause for many cases of MDS is unclear, there are several factors that are suspected to contribute to its development.  A combination of these factors could increase the risk of getting MDS.

  • Genetics

A mutation in the gene responsible for controlling the development of blood cells is believed to increase the chances of developing MDS. In addition, medical conditions inherited from the parents are supposed to be contributors as well.  These include congenital neutropenia, Shwachman-Diamond syndrome and Fanconi anemia. 

  • Cancer therapy

Chemotherapy drugs used to treat cancer could add to the risk of the development of therapy-related MDS or secondary MDS.  Therapy related MDS accounts for about ten percent of the total MDS cases. Some of these drugs are Adriamycin, Cytoxan, Etopophos, Leukeran and Ifex. 

  • Exposure to industrial chemicals and tobacco smoke

Long term exposure to hazardous chemicals and tobacco or cigarette smoke increases an individual’s risk of developing MDS. A good example of highly toxic industrial chemical is benzene. 

  • Exposure to radiation

High levels of radiation, such as in radiotherapy during cancer treatment, could contribute the MDS development. 

Signs and Symptoms

The signs and symptoms of Myelodysplastic Syndrome greatly vary, depending on the kinds of blood cells affected and the severity of the disease.  Generally, when the condition is in its early stages, it is asymptomatic and could only be found out through blood testing.  As the disease progresses, the hallmark symptoms are one or more of the following: 

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  • Bleeding and bruising

The sudden appearance of bruises and episodes of bleeding for no clear reason is a manifestation of this condition due to very low levels of platelet in the blood. 

  • Anemia

When the number of red blood cells is low, it will lead to anemia which causes paleness, fatigue, dizziness and shortness of breath. 

  • Frequent infections

Because healthy white blood cells which combat infection are reduced, an individual with MDS is more susceptible to infections.  These infections will also heal slowly and recur.

Diagnosis and Treatment

To diagnose MDS, the doctor will assess the symptoms and check the patient’s medical history.  In addition, blood tests to get the blood count and check the blood cells; and bone marrow biopsy to analyze the bone marrow can confirm the condition.

Once Myelodysplastic Syndrome has been confirmed, the treatment strategy will be designed by the doctor based on the type of MDS the patient has and the severity of the condition.  MDS may be addressed using an assortment of treatment methods, ranging from regular monitoring for early stages with mild to no symptoms; to chemotherapy and even stem cell transplant for very severe cases. 

  • Supportive care

Supportive treatment plays a major role in the treatment of MDS as it is aimed to prevent and treat infections as well as possible complications. Growth factors and blood transfusions to increase the number of red blood cells and platelets may be needed by those who suffer from anemia and thrombocytopenia. Meanwhile, antibiotics will be prescribed for infections. 

  • Chemotherapy

Chemotherapy drugs are administered following a protocol for those with severe MDS to control the increase of blast cells and get the bone marrow to produce healthy blood cells. 

  • Stem cell transplant

This is the only method that comes close to curing MDS.  The stem cells that come from a donor will be transplanted.  However, the difficulty lies in finding a well-matched donor, not to mention that the procedure has its risks too.  

Myelodysplastic Syndrome – Life Expectancy and Prognosis 

The prognosis for Myelodysplastic Syndrome differ widely as multiple factors come into play, such as the type of MDS, the severity, the health, as well as the age of the patient.  In general, those who are diagnosed early, who are healthier and younger have better chances.  The median survival ranges from 12 years for the very low risk group, to as short as 9 months for those under the very high risk group.  The risk of developing leukemia is 3% and 84%, respectively. Still, each case is unique and so the outlook differs for every patient.

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