MDS | Specialists and information about the disease

What is myelodysplastic syndrome?

Myelodysplastic syndrome (MDS) is a group of diseases that affect blood formation. Different types of blood cells develop in the bone marrow and take on different tasks in the body:

• The white blood cells (leukocytes) are associated with the immune system. They fight pathogens and are the body's health police.
• The red blood cells (erythrocytes) regulate the transportation of oxygen in the blood.
• Platelets (thrombocytes) are responsible for coagulation.

If there are not enough leukocytes, erythrocytes or thrombocytes or if they are malformed, the patient has myelodysplastic syndrome.

Specialists differentiate between myelodysplastic syndrome as follows:

1. If two of the three cells are affected, it is called bizytopenia.
2. If all three cells are affected, it is called pancytopenia.

Myelodysplastic syndrome usually affects older people from the age of 60. Statistically, the disease is slightly more common in men than in women.

Symptoms of myelodysplastic syndrome

As MDS is a blood disorder, various symptoms (including leukemia) occur:

• Anemia: The reason for this is the insufficient formation of red blood cells. Anemia is one of the accompanying symptoms in a large proportion of patients. If the anaemia is already well advanced, a transfusion may even be necessary.
• Increased susceptibility to infection: This occurs when the formation of white blood cells does not function properly (leukopenia). The immune system only functions to a limited extent and is unable to fight off infections.
• Bleeding tendency: If the formation of blood platelets is impaired, patients can bleed more easily.
• Lack of blood clotting: Another side effect is the lack of blood clotting in wounds. Small, visible bleedings develop under the skin.
• Enlarged spleen or enlarged liver: These can occur in addition to the symptoms already mentioned.
• Development of leukemia

The typical symptoms of anemia are fatigue, tiredness and paleness @ agenturfotografin /AdobeStock

How does myelodysplastic syndrome develop?

As already mentioned, MDS is caused by the defective formation of individual blood cells in the bone marrow. In the majority of patients, specialists do not know why this defective blood formation occurs.

If there is no explainable connection, experts speak of primary myelodysplastic syndrome. Secondary myelodysplastic syndrome, on the other hand, can be attributed to certain factors:

For example, radiation, chemotherapy, iodine therapy for thyroid problems and exposure to certain chemicals can trigger MDS.

Diagnosis of myelodysplastic syndrome?

The diagnosis of MDS is made in several steps:

1. In a medical history interview, the attending physician asks the patient about their symptoms and whether they have any pre-existing conditions.
2. To find out whether it is a blood disorder, he or she will order a blood test.
3. A physical examination may also be useful to detect an enlarged spleen or liver.
4. During a bone marrow puncture, the doctor takes tissue from the bone marrow and has it examined in a laboratory. This also provides information about possible forms of therapy.

Treatment for myelodysplastic syndrome

In order to prescribe the best possible treatment, doctors differentiate between two forms of the disease: Low-risk MDS and high-risk MDS.

Treatment of low-risk MDS

In low-risk MDS, transfusions, vaccinations and antibiotics are used. Preparations that bind the iron in the blood also play a role. This is because transfusions can lead to a high concentration. Doctors also use certain drugs that stimulate the growth of individual blood cells.

Two thirds of MDS patients require regular blood transfusions @ somchai20162516 /AdobeStock

Treatment of high-risk MDS

There are also various options for treating high-risk MDS. For example, the doctor can use medication to influence the DNA metabolism. Alternatively, stem cell therapy can also be used. Stem cell therapy can even lead to a complete cure. However, patients need a suitable donor who is genetically similar to the patient.

Possible forms of therapy are

• Transfusions
• vaccinations
• Administration of iron chelators
• Intervention in the DANN metabolism
• Stem cell therapy

What is the prognosis for myelodysplastic syndrome?

It is rather difficult for doctors to make a prognosis because it depends on various factors. For example, the patient's general constitution is important. The average life expectancy can vary greatly. It ranges from a few months (high-risk MDS) to several years (low-risk MDS).