Myelodysplastic Syndromes: Symptoms, Causes & Treatment

Myelodysplastic syndromes (MDS) are a group of bone-marrow disorders in which the marrow's stem cells fail to produce enough mature, healthy blood cells. As a result, abnormal cells form and the counts of red cells, white cells, or platelets, or all together, fall.

These syndromes mostly affect older adults and vary in severity from mild, slowly progressive cases to high-risk cases that can transform into acute myeloid leukemia. Doctors therefore classify the disease into risk groups that help select appropriate treatment and estimate the expected course.

There may be no symptoms at first, and the disease is found on a routine blood test; then symptoms of anemia, recurrent infections, and bleeding appear depending on the type of deficiency. Diagnosis is confirmed by a bone-marrow examination and genetic tests. Treatment depends on the risk level, ranging from transfusion support and marrow-stimulating agents to disease-modifying drugs, up to bone-marrow transplant, the only potentially curative treatment in selected cases.

• Fatigue, pallor, and shortness of breath (anemia).
• Recurrent infections (low white cells).
• Easy bruising and bleeding (low platelets).
• There may be no symptoms in early stages.

• Usually an unknown cause, linked to aging.
• Prior chemotherapy or radiotherapy.
• Long-term exposure to certain chemicals such as benzene.

• Complete blood count and blood smear.
• Bone-marrow examination (aspirate and biopsy).
• Genetic and chromosomal tests to determine risk.

Lower risk

• Monitoring and support with transfusions and red-cell stimulating agents.

Higher risk

• Disease-modifying drugs such as hypomethylating agents.
• Bone-marrow transplant, the potentially curative option in selected patients.

This content is educational and does not replace consulting a hematologist.

• Severe anemia needing frequent transfusions.
• Serious infection and bleeding.
• Transformation into acute myeloid leukemia.

• There is no proven prevention.
• Avoid exposure to harmful chemicals such as benzene.
• Follow-up after prior chemotherapy or radiotherapy.