Myelodysplastic Syndromes

What are myelodysplastic syndromes?

Myelodysplastic syndromes (MDS) are a group of diseases that affect the bone marrow and production of blood cells. Although children and young adults sometimes have MDS, most people with MDS are over 60 years old.

MDS may also be called myelodysplasia or preleukemia.

How does it occur?

Healthy bone marrow produces stem cells, which can develop into 3 types of blood cells: red blood cells, white blood cells, and platelets. When the bone marrow malfunctions and the stem cells fail to mature fully, it is called MDS. The marrow of people with MDS produces too many immature blood cells called blasts. These blast cells cannot function properly as blood cells. They also collect in the bone marrow, damaging it further.

What causes MDS is not known. It may be caused by exposure to pesticides, herbicides, and the chemical benzene, which is found in unleaded gasoline.

What are the symptoms?

The most common symptoms of myelodysplastic syndromes are:

• anemia
• fatigue
• shortness of breath
• paleness
• frequent infections
• easy bruising and bleeding.

How is it diagnosed?

Because other problems can cause the symptoms, diagnosis can be made only after careful tests of the bone marrow and blood.

• A sample of your blood will be checked to see which type of blood cells is malformed.
• A sample of bone marrow may be taken from your breastbone or hipbone. First you will be given a local anesthetic to numb the area. A needle is then passed gently through the skin into the bone marrow. Using a syringe, your healthcare provider takes a tiny sample of bone marrow to examine under a microscope.

How is it treated?

There are several ways to treat myelodysplasia:

• blood transfusions
• chemotherapy (anticancer drugs)
• replacement of the cells the bone marrow is not making
• bone marrow transplant, a very risky treatment that is used mainly in young people with this disorder
• supportive care.

Treatment depends upon the severity of the disease, your age, and your overall health. Older adults who have other health problems may choose supportive care. Supportive care does not cure MDS. It seeks to limit its effects. Supportive care includes transfusions of red blood cells or platelets, and taking antibiotics, vitamins, and other medicines to ease the symptoms.

How long do the effects last?

People with mild forms of MDS may live for several years with few problems. MDS can sometimes develop into a form of leukemia, most often acute myelogenous leukemia. People with the more severe form may not survive very long.

Currently, only stem cell transplants can cure MDS. Other types of treatment can prolong life and decrease the symptoms.

How can I take care of myself with MDS?

• Avoid contact with chemicals such as gasoline, kerosene, paint, pesticides, and cleaning agents.
• Talk to your healthcare provider about exercise, such as walking or riding a stationary bicycle.
• If you have low red blood cell counts, avoid exercising too much, going to high altitudes, or any activity that causes chest pain, shortness of breath, or a fast heart rate.
• If you have low white blood cell counts, keep track of your temperature, and get medical help right away if you have a fever higher than 100.4°F, or 38°C.
• Avoid cuts, burns, and other injuries.
• Take all medicines as prescribed by your healthcare provider.
• Eat a healthy diet. This helps support your body and keeps up your strength.
• Join a support group in your community.
• Call your healthcare provider when you have any questions about your condition or treatment.
• If you get a severe headache, or severe pain anywhere, contact your healthcare provider right away.

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