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Understanding Myelodysplastic Syndromes (MDS)

Myelodysplastic syndromes (MDS), also known as myelodysplasia, are a group of cancerous disorders that impede the maturation of blood stem cells into healthy blood cells. MDS can lead to serious conditions such as anemia, frequent infections, and uncontrolled bleeding. In some individuals with MDS, acute myeloid leukemia may develop.

How MDS Develops

MDS develops when something goes wrong with the production of blood cells. Blood cells are produced in your bone marrow, which is the soft, spongy material at the center of your bones. Your bone marrow manages the production of blood cells, nourishing the blood stem cells and moving the mature blood cells into your body.

Myelodysplastic syndromes arise when your blood stem cells fail to mature into healthy blood cells. Instead, these stem cells ultimately die in your bone marrow or shortly after entering your bloodstream. In a sense, your bone marrow is like a store owner who needs to keep perishable goods moving, so they can stock new goods. When this doesn’t happen, the store owner can’t restock.

Similarly, when your stem cells don’t mature and leave the bone marrow, there is less space for healthy cells. Having fewer blood cells than normal increases the likelihood of developing serious health problems.

The Role of Different Blood Cells

Blood stem cells are immature cells that can give rise to several different cell types. Blood stem cells are expected to mature into either myeloid stem cells or lymphoid stem cells.

• A lymphoid stem cell becomes a type of white blood cell (leukocyte).
• A myeloid stem cell becomes one of three types of blood cells:
  1. Red blood cells (erythrocytes) carry oxygen and other substances to all the tissues of your body. You may develop anemia if you don’t have enough red blood cells.
  2. Leukocytes (white blood cells) fight infections and diseases. Without an adequate number of leukocytes, you may develop recurrent infections.
  3. Platelets (thrombocytes) prevent bleeding more than usual. A condition where platelets are low is called thrombocytopenia.

Who is at Risk of Myelodysplastic Syndromes?

Approximately 20,000 people are diagnosed with myelodysplastic syndromes annually. MDS affects around 27 people per 100,000 individuals aged 70 to 79 years and 55 people per 100,000 individuals aged 80 years and older. Children and younger adults can develop myelodysplastic syndrome, but this is less common. MDS develops in less than 4 children or young adults per 1 million.

Here are some additional details on who may have a higher risk of developing myelodysplastic syndrome:

• People assigned male at birth have a higher likelihood of developing myelodysplastic syndromes than people assigned female at birth.
• White people have a higher probability of developing myelodysplastic syndromes compared to people of color.

Symptoms and Causes

What are the symptoms of myelodysplastic syndrome? You may have MDS without any symptoms. Sometimes people learn they have the syndrome after routine blood tests. Anemia is the most common symptom of myelodysplastic syndrome. But the symptoms of anemia and other MDS symptoms can resemble those of less serious conditions. Consult your healthcare provider if you notice the following changes, especially if they don’t go away within a few weeks:

• You feel short of breath.
• You feel weak or severely fatigued, and resting doesn’t help you feel less tired.
• You notice your skin has become paler than usual. If you have dark skin, your healthcare provider may check your inner eyelids and mucous membranes for color loss.
• You develop bruises or bleeding more often than usual.
• You notice tiny, dot-sized spots on your skin. This may be a sign of petechiae – tiny bleeding spots under the skin.
• You have frequent infections and fever.

Is Myelodysplasia a Form of Leukemia?

Myelodysplastic syndromes are a group of cancerous disorders, but not all individuals with MDS develop overt acute myeloid leukemia. Approximately one-third of people with MDS go on to develop acute myeloid leukemia.

What Causes Myelodysplastic Syndromes?

People develop MDS in one of two ways: due to actions that increase the risk of developing MDS, or through genetic changes that occur spontaneously. Some risk factors for MDS include: