Myelodysplasticsyndromes (MDS) are a group of bone marrow diseases.
They have a higher risk of becoming acute myelogenous leukemia (AML).
These diseases all have different symptoms and treatments.
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These diseases affect how thebone marrowcreates healthy blood cells.
About 10,000 people develop MDS in the United States each year.
MDS is also called preleukemia,hematopoietic dysplasia, subacute myeloid leukemia, oligoblastic leukemia, or smoldering leukemia.
How Does MDS Develop?
MDS begins with DNA damage in a single blood-formingstem cell.
The bone marrow starts to make too many blood cells and gets packed with immature cells.
These are also called “blast” cells.
There is also an increase in cell death.
This is why people with MDS often have complications related to a lack of blood cells.
Platelets help the blood clot to stop bleeding.
Red blood cells help circulate oxygen in the body.
White blood cells help fight infections and disease.
Risk Factors
The cause of MDS is not known.
The number of blast cells in the marrow shows how severe the disease is.
More immature cells mean more severe disease.
MDS Subtypes
MDS includes several different bone marrow disorders.
Each condition has subtypes that determine the behavior and outcome.
There are a few classification systems that have a go at cover these different types.
FAB classification
The first system is the French-American-British (FAB) classification.
It breaks MDS down into 5 subtypes.
Since then, scientists have learned more about the genetic abnormalities that lead to MDS.
They have also studied how these mutations impact the course of the disease.
They also explained that greater than 20% of blasts in the marrow was considered AML.
IPSS
The third system is the International Prognostic Scoring System (IPSS).
It uses three criteria for determining how MDS will progress:
IPSS divides patients into four categories.
Recap
There are a few systems to help classify MDS disorders.
Some types are divided into subtypes based on how many blast cells are in the bone marrow.
Primary vs.
Secondary MDS
In most patients, MDS seems to develop suddenly for no known reason.
This is called primary orde novoMDS.
Scientists are not sure what causes primary MDS.
Secondary MDS means the disease follows previous treatment with chemotherapy or radiation therapy.
Diagnosis
MDS is diagnosed using the same techniques used todiagnose leukemia.
The first test is a complete blood count (CBC).
This gives an idea of what is going on in the marrow.
A person with MDS will usually have low numbers of red blood cells.
They could have low platelets and white blood cells as well.
If there is no other clear cause for anemia, the doctor will perform abone marrow aspirate and biopsy.
This involves inserting a needle into the bone to remove a test sample.
A patient with MDS will have abnormal bone marrow and an increased number of blast cells.
They will also show mutations or changes to the chromosomes.
This may include bleeding problems and difficulty fighting off infections.
There are many other, less serious conditions that can cause these signs and symptoms.
It is best to discuss any health concerns with your doctor.
Summary
MDS is not one disease.
It is a group of conditions that cause changes to how the bone marrow functions.
Scientists continue to learn more about genetics and how these diseases develop.
They are also learning more about risks and the outcomes of these diseases.
Researchers can use this information to create new and more effective therapies for MDS.
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