Myelodysplastic Syndromes

What are myelodysplastic syndromes?

Myelodysplastic syndromes (MDS) are a group of diseases in which the bone marrow does not make enough healthy blood cells.

Although children and young adults sometimes have MDS, most people with MDS are over 60 years old.

MDS may also be called myelodysplasia or preleukemia.

What is the cause?

Healthy bone marrow makes stem cells, which develop into 3 types of blood cells: red blood cells, white blood cells, and platelets. MDS can happen when the stem cells do not develop properly into mature blood cells. Instead the bone marrow makes too many immature blood cells called blasts. The blasts do not mature and cannot work properly as blood cells. They also collect in the bone marrow and leave less room for healthy blood cells.

What causes MDS is not known. It may be caused by exposure to pesticides, herbicides, and the chemical benzene, which is found in unleaded gasoline.

What are the symptoms?

The most common symptoms of myelodysplastic syndromes are:

• tiredness
• shortness of breath
• paleness
• frequent infections
• easy bruising and bleeding.

How is it diagnosed?

Because other problems can cause the symptoms, diagnosis can be made only after careful tests of the blood and bone marrow. Tests you may have include:

• Blood tests to count the different kinds of blood cells.
• Tests of a sample of bone marrow taken from your breastbone or hipbone. First you will be given a local anesthetic to numb the area. A needle is then passed through your skin into the bone marrow. Using a syringe, your healthcare provider takes a tiny sample of fluid and tissue to examine under a microscope. This procedure is called a bone marrow biopsy.

How is it treated?

There are several ways to treat myelodysplasia:

• blood transfusions to replace the cells the bone marrow is not making
• chemotherapy (anticancer drugs) to stop the growth of immature blood cells
• transplant of healthy stem cells from a donor after you have chemotherapy.

Treatment depends upon the severity of the disease, your age, and your overall health. Older adults who have other health problems may choose supportive care. Supportive care does not cure MDS. It seeks to limit its effects. Supportive care includes transfusions of red blood cells or platelets, and taking antibiotics, vitamins, and other medicines to ease the symptoms.

How long do the effects last?

People with mild forms of MDS may live for several years with few problems. People with a more severe form of MDS may not live long after developing the disease.

MDS can sometimes develop into a form of leukemia, most often acute myelogenous leukemia.

Currently, only stem cell transplants can cure MDS. Other types of treatment may help you live longer and decrease the symptoms.

How can I take care of myself?

• Take all medicines as prescribed by your healthcare provider.
• Talk to your healthcare provider about exercise, such as walking or riding a stationary bicycle.
• If you have low red blood cell counts, avoid exercising too much, going to high altitudes, or doing any activity that causes chest pain, shortness of breath, or a fast heart rate.
• Eat a healthy diet. This gives your body the nutrition it needs to make healthy blood cells. It also helps you keep up your strength.
• If you have low white blood cell counts, keep track of your temperature, and get medical help right away if you have a fever higher than 100.4°F (38°C).
• Try to avoid cuts, burns, and other injuries.
• Join a support group in your community.
• Contact your healthcare provider right away if:
  • You have a severe headache or severe pain anywhere in your body.
  • You are having bleeding problems--for example, nosebleeds or blood in your bowel movements.
• Call your healthcare provider when you have any questions about your condition or treatment.

How can I help prevent MDS?

It may help to avoid excessive contact with chemicals such as gasoline, kerosene, paint, pesticides, and cleaning agents. Always follow instructions and have good ventilation when you are working with these chemicals.