Pronounced: My-e-lo-dys-plas-tic syn-dromes
Myelodysplastic syndromes (MDS) are a group of diseases that involve dysfunction of the bone marrow. Bone marrow is the tissue found within the bones; its task is to create mature blood cells from stem cells. In all forms of MDS, this normal cell-creation process is disrupted by the overproduction of clones of a single stem cell. This leads to a decrease in production of normal red blood cells, white blood cells, and platelets.
The World Health Organization has classified MDS into eight categories. Some forms are more serious than others; all of them are serious enough to require a physician’s care. Thirty percent of people with MDS develop acute myeloid leukemia (AML). Leukemia is a cancer of the white blood cells and their parent cells. As more is learned about MDS, experts began to see it as a form of cancer.
The cause of MDS is unknown, but research shows that certain risk factors are associated with the disease.
A risk factor is something that increases your chance of getting a disease or condition.
The following factors are associated with a higher risk for developing MDS:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. The symptoms for MDS can indicate many other conditions. Doctors have to rule out other conditions before diagnosing MDS.
Tests may include the following:
Treatment for MDS depends on your age, other medical conditions, and how serious the disease is. Treatment also depends on how far along the disease has progressed to AML. Often, treatment includes relieving the symptoms of MDS. Talk with your doctor about the best treatment plan for you. You may be referred to a hematologist and an oncologist. A hematologist specializes in blood diseases. An oncologist specializes in cancer. Treatment options include:
If you have a low red blood cell, white blood cell, or platelet count, you may receive a blood transfusion. A blood transfusion is a treatment that involves receiving blood products (red cells, white cells, platelets, clotting factors, plasma, or whole blood) through a vein. The blood components may come from an unrelated donor, from a related donor, or may have been banked in advance by the recipient.
If you have a low white blood cell count, you may receive antibiotics to fight infection.
Growth factors help the bone marrow produce blood cells. The following growth factors may be used to treat MDS:
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
There are three combinations of chemotherapy drugs used to treat MDS. These combinations include:
Hypomethylating agents are drugs that slow down the growth of cells, and include:
Immunomodulating drugs change the immune system, and include:
Immunosupression agents suppress the immune system, and include:
The only cure for MDS is a stem cell transplant (SCT) . A SCT starts with high-dose chemotherapy to kill the bone marrow, and is then followed by an injection of healthy stem cells. The stem cells used can come from the blood or bone marrow.
There are two types of SCT. The less common one is called an autologous SCT, and occurs when the patient is injected with her own cells after high-dose chemotherapy. The more common method is called allogeneic and occurs when a patient gets donor cells after high-dose chemotherapy.
Many doctors will only perform an SCT on a patient that is aged 50 or younger.
To help reduce your chances of getting MDS, take the following steps:
RESOURCES:
American Cancer Society
http://www.cancer.org
Leukemia and Lymphoma Society
http://www.leukemia-lymphoma.org
Myelodysplastic Syndromes Foundation
http://www.mds-foundation.org
CANADIAN RESOURCES:
Aplastic Anemia and Myelodysplasia Association of Canada
http://www.aamac.ca
Neutropenia Support Association
http://www.neutropenia.ca
References:
Ableoff M, ed. Clinical Oncology. 4th ed. Philadelphia, PA: Elsevier; 2005.
Ableoff M, ed. Clinical Oncology. 3rd ed. Philadelphia, PA: Elsevier; 2004.
Cancer Prevention page. American Cancer Society website. Available at: http://www.cancer.org/docroot/PED/ped_1.asp?sitearea=PED . Accessed September 28, 2005.
Detailed guide: myelodysplastic syndrome. American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=65. Accessed April 2, 2009.
Frequently asked questions about MDS page. The Myelodysplastic Syndromes Foundation website. Available at: http://www.mds-foundation.org/pdf/CEL411%20Factsht%20v8.pdf . Accessed September 14, 2005.
Goldman L, ed. Cecil Textbook of Medicine. 22nd ed. Philadelphia, PA: W.B. Saunders Company; 2004.
Hoffman R, Benz E, Shattil S, et al, eds. Hematology: Basic Principles and Practice. 4th ed. Philadelphia, PA: Elsevier; 2005.
Myelodysplastic syndrome. Dynamed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase . Accessed September 13, 2005.
Myelodysplastic syndromes: a review for patients, families, friends, and healthcare professionals. Patient information page. The Myelodysplastic Syndromes Foundation website. Available at: http://www.mds-foundation.org/patientinfo.htm . Accessed September 14, 2005.
Myelodysplastic syndromes facts & statistics page. Leukemia and Lymphoma Society website. Available at: http://www.leukemia-lymphoma.org/all_page?item_id=55445 . Accessed September 22, 2005.
Myelodysplastic syndromes page. National Marrow Donor Program website. Available at: http://www.marrow.org/PATIENT/myelodysplastic_syndromes.html . Accessed September 22, 2005.
Myelodysplastic syndromes: treatment page. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/myelodysplastic . Accessed: September 22, 2005.
Overview: myelodysplastic syndrome page. American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1x_What_Are_Myelodysplastic_Syndromes_65.asp?rnav=cri . Accessed September 22, 2005.
Understanding myelodysplastic syndromes: a patient handbook. Patient information page. The Myelodysplastic Syndromes Foundation website. Available at: http://www.mds-foundation.org/patientinfo.htm . Accessed September 14, 2005.
Last reviewed April 2009 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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