What is Myelodysplastic Syndrome (MDS)

Myelodysplastic syndrome is a group of cancers that affect blood cells. New blood cells are also called immature cells or stem cells. MDS starts in the bone marrow where new blood cells are made. The bone marrow makes:

• Red blood cells. These carry oxygen.
• White blood cells. These fight infection.
• Platelets. These stop bleeding.

With MDS, some immature cells do not grow into adult blood cells. These cells will die before they reach maturity. Immature blood cells build up in the bone marrow and crowd out normal adult blood cells.

This causes a low blood count and can affect how many healthy red blood cells, white blood cells, and platelets you have. If you have too few red blood cells, your blood may not have enough oxygen, and you will feel tired.

If you do not have enough white blood cells, you might get infections often. If you have too few platelets, you may bruise or bleed easily.

What are the causes?

This condition may be caused by:

• Being exposed to certain medicines or chemicals.
• Radiation treatment.

In some cases, the cause may not be known.

What increases the risk?

This condition is more likely to develop in:

• Caucasians.
• Males.
• People who are 60 years of age or older.
• People who have been treated with cancer medicines or radiation.
• People who have been exposed to tobacco smoke, pesticides, lead, mercury, or the benzene chemical.
• People with a family history of MDS.
• People who inherit certain abnormal genes that lead to bone marrow problems.

What are the signs or symptoms?

Symptoms often develop slowly over time. Symptoms depend on which blood cells are affected. Symptoms include:

• Being tired all the time.
• Feeling out of breath.
• Having pale skin.
• Getting infections often.
• Having pain in the bones.
• Feeling weak.
• Having a fever often.
• Bruising easily.
• Bleeding that lasts longer than normal.
• Having tiny spots of bleeding under the skin (petechiae).

How is this diagnosed?

This condition is diagnosed based on your symptoms, medical history, and physical exam. You may also have tests, including:

• A complete blood count. This test counts the number of red, white, and platelet blood cells.
• Peripheral blood smear. This test checks the number and type of blood cells. It also checks their size and shape.
• Bone marrow aspiration and biopsy. Aspiration involves using a needle to remove the liquid portion of the bone marrow, and a biopsy involves removing the bone marrow tissue. The samples removed will be examined under a microscope.

How is this treated?

There is no cure for MDS. Treatment focuses on relieving your symptoms and slowing down the production of immature blood cells. The type of treatment that is best for you depends on the type of MDS you have. Treatment may include:

• Blood transfusions.
• Chemotherapy. This is the use of medicines to kill cancer cells.
• Targeted therapy. This treatment targets specific parts of cancer cells and the area around them to block the growth and spread of the cancer.
• Immunotherapy or biologic therapy. This treatment helps your body boost its own immune system and natural defenses to stop the growth and spread of cancer cells.
• Medicines that:
  • Slow down the number of immature blood cells that are made.
  • Help immature cells develop into adult cells.
  • Make more blood cells.
  • Treat infections (antibiotics).
• Bone marrow stem cell transplant. In this procedure, your stem cells will be replaced with healthy stem cells from a donor.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take aspirin unless your health care provider approves. Aspirin can make bleeding more likely.
• If you were prescribed an antibiotic, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Lifestyle

• Avoid dangerous activities that could lead to bleeding. Ask your health care provider what activities are safe for you.
• Wash all fruits and vegetables before eating them. Make sure meat and eggs are well cooked. Do not eat raw fish and shellfish.
• Wash your hands often with soap and water. If soap and water are not available, use hand sanitizer.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

• Stay away from people who are sick.
• Keep all follow-up visits as told by your health care provider. This is important.
• Talk to your health care provider before having any medical or dental procedure.

Contact a health care provider if:

• You feel more tired than normal.
• You have more bruising than usual.
• You have trouble catching your breath.
• You have any symptoms of infection, such as:
  • Fever.
  • Chills.
  • Abnormal urinary symptoms.
  • Cough.
  • Body aches.
  • Headache.
  • Weakness.
  • Dizziness.

Get help right away if:

• Your symptoms get worse.
• You have bleeding that does not stop.
• You have trouble breathing.
• You have chest pain.