Myelodysplastic Syndromes

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KEY POINTS

• Myelodysplastic syndromes (MDS) are a group of diseases in which your bone marrow does not make enough healthy blood cells. Some people may live for many years with few problems. People with a more severe form of MDS may not live long after developing the disease.
• Treatment depends upon the severity of the disease, your age, and your overall health. It may include blood transfusions, chemotherapy, or a stem cell transplant.
• Follow the full course of treatment prescribed by your healthcare provider. Talk to your healthcare provider about exercise, how to eat a healthy diet, and how to take care of yourself at home.

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What are myelodysplastic syndromes?

Myelodysplastic syndromes (MDS) are a group of diseases in which your bone marrow does not make enough healthy blood cells. MDS may also be called myelodysplasia or preleukemia. MDS can sometimes develop into a form of leukemia.

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.

What is the cause?

Healthy bone marrow makes immature blood cells called stem cells. Stem cells normally develop into mature red blood cells, white blood cells, and platelets. MDS happens when the bone marrow makes too many immature blood cells that do not develop into mature blood cells. The immature blood cells cannot work properly. They also collect in the bone marrow and leave less room for healthy blood cells.

The exact cause of MDS is not known. It may be caused by being exposed to chemicals found in pesticides, cigarette smoke, and unleaded gas. Past treatment with chemotherapy or radiation may also increase the risk for MDS. Although children and young adults sometimes have MDS, most people with MDS are over 60 years old.

What are the symptoms?

In the early stages, MDS usually does not cause symptoms. Later symptoms may include:

• Feeling unusually weak and tired
• Pale skin and gums or other skin changes such as bruises or tiny red spots on the skin
• Shortness of breath
• Frequent infections
• Easy bleeding

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• A bone marrow biopsy, which uses a needle passed through the skin into your breastbone or hipbone to take a small sample of tissue for testing

How is it treated?

Treatment depends upon the severity of the disease, your age, and your overall health. There are many 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

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

Older adults who have other health problems may choose supportive care. Supportive care does not cure MDS, but can ease symptoms. Supportive care includes transfusions of red blood cells or platelets, and taking antibiotics, vitamins, and other medicines. It does not include chemotherapy or stem cell transplants.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will get your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

It may also help to:

• Talk to your healthcare provider about exercise, such as walking or riding a stationary bicycle. If you have low red blood cell counts, it is best to 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.
• Try to avoid cuts, burns, and other injuries.
• Join a support group in your community.