Myelodysplastic syndrome (MDS)
Disease information
Overview
Myelodysplastic Syndrome (MDS) is a form of blood cancer that starts in the bone marrow's hematopoietic stem cells, which are responsible for generating new blood cells. This condition disrupts the usual process of blood cell formation, known as hematopoiesis, and can lead to lower counts of white blood cells, red blood cells, or platelets. These changes are often initially detected through routine blood tests.
For a definitive diagnosis, a bone marrow biopsy is performed, which typically shows dysplastic cells—cells that are abnormally shaped and indicative of an abnormal cell differentiation process not seen in healthy individuals. In some cases, an increased number of blasts, or immature blood cells often associated with leukemia, can be found in the bone marrow.
Historically termed a 'syndrome,' MDS was reclassified by the World Health Organization in 2022 as a 'neoplasm' to better reflect its cancerous nature. MDS predominantly affects older adults and may be linked to previous treatments with chemotherapy or immunosuppressive drugs for other conditions, leading to what is known as therapy-related or secondary MDS.
Causes & Symptoms
Myelodysplastic Syndrome (MDS) is a form of blood cancer that starts in the bone marrow's hematopoietic stem cells, which are responsible for generating new blood cells. This condition disrupts the usual process of blood cell formation, known as hematopoiesis, and can lead to lower counts of white blood cells, red blood cells, or platelets. These changes are often initially detected through routine blood tests. For a definitive diagnosis, a bone marrow biopsy is performed, which typically shows dysplastic cells—cells that are abnormally shaped and indicative of an abnormal cell differentiation process not seen in healthy individuals.
In some cases, an increased number of blasts, or immature blood cells often associated with leukemia, can be found in the bone marrow. Historically termed a 'syndrome,' MDS was reclassified by the World Health Organization in 2022 as a 'neoplasm' to better reflect its cancerous nature. MDS predominantly affects older adults and may be linked to previous treatments with chemotherapy or immunosuppressive drugs for other conditions, leading to what is known as therapy-related or secondary MDS.
Treatment
Selecting the right treatment for Myelodysplastic Syndrome (MDS) depends on a careful review of the patient's overall health and the specific risks posed by their form of the disease. Doctors use tools like the Revised International Prognostic Scoring System (IPSS-R) or IPSS-M to figure out a patient's risk level. If the risk is high and the patient is in good general health, an aggressive treatment plan might be considered.
For those at low risk, the goal is usually to manage symptoms. Transfusions of red blood cells or platelets can help with severe anemia or a low platelet count. Other treatments might include drugs that stimulate red blood cell production, hormones known as androgens, or drugs that inhibit a protein called TGF-β. For high-risk patients, the priority is to control the disease quickly to protect the patient's life. Treatments might include drugs that modify how genes are expressed (hypomethylating agents), high-dose chemotherapy, or allogeneic hematopoietic stem cell transplantation, which is currently the only potential cure. The success of a stem cell transplant can depend a lot on things like the patient's age, how advanced their disease is, the treatment they've had before the transplant, and how closely the donor's HLA genes match the patient's.
On top of these established treatments, there's a lot of research going on, with clinical trials testing new drugs and trying to improve how MDS is treated.