MDS | Specialists and Information on the Disease

Myelodysplastic syndrome (MDS) is a group of disorders that affect blood formation. Various types of blood cells develop in the bone marrow, each performing different functions in the body:

• White blood cells (leukocytes) are associated with the immune system. They fight pathogens and act as the body’s “health police.”
• Red blood cells (erythrocytes) regulate the transport of oxygen in the blood.
• Platelets (thrombocytes) are responsible for blood clotting.

If there are insufficient leukocytes, erythrocytes, or thrombocytes, or if they are malformed, this indicates myelodysplastic syndrome.

Specialists classify myelodysplastic syndrome as follows:

1. If two of the three cell types are affected, the condition is called bicytopenia.
2. If all three cell types are affected, it is called pancytopenia.

Myelodysplastic syndrome most commonly affects older adults aged 60 and older. Statistically, the disease is slightly more common in men than in women.

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

• Anemia: This is caused by insufficient production of red blood cells. Anemia is a common complication in a large proportion of patients. If the anemia is already advanced, a blood transfusion may even be necessary.
• Increased susceptibility to infection: This occurs when white blood cell production is impaired (leukopenia). The immune system functions only to a limited extent and is unable to fight off infections.
• Tendency to bleed: If platelet production is impaired, patients may bleed more easily.
• Impaired blood clotting: Another associated symptom is impaired blood clotting at wound sites. Small, visible bleeds develop under the skin.
• Enlarged spleen or enlarged liver: These may occur in addition to the symptoms already mentioned.
• Development of Leukemia

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

As mentioned earlier, MDS involves the abnormal formation of individual blood cells in the bone marrow. In the majority of patients, specialists do not know why this abnormal blood formation occurs.

When there is no identifiable cause, experts refer to it as primary myelodysplastic syndrome. Secondary myelodysplastic syndrome, on the other hand, can be attributed to specific factors:

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

The diagnosis of MDS involves several steps:

1. During a medical history interview, the treating physician asks the patient about their symptoms and any pre-existing conditions.
2. To determine whether it is a blood disorder, the doctor will order a blood test.
3. A physical examination may also be helpful to check for an enlarged spleen or liver.
4. During a bone marrow aspiration, the doctor removes tissue from the bone marrow and has it examined in a laboratory. This also provides information about possible treatment options.

To determine the best possible treatment, doctors distinguish between two forms of the disease: low-risk MDS and high-risk MDS.

Treatment for Low-Risk MDS

For low-risk MDS, treatments include blood transfusions, vaccinations, and antibiotics. In addition, medications that bind iron in the blood play a role, as transfusions can lead to high iron concentrations. Furthermore, doctors use certain medications that stimulate the growth of individual blood cells.

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

Treatment of High-Risk MDS

Various treatment options are also available for high-risk MDS. For example, doctors can use medication to influence DNA metabolism. Alternatively, stem cell therapy may be used. Stem cell therapy can even lead to a complete cure. However, patients require a suitable donor who is genetically compatible with them.

Possible treatment options include:

• Transfusions
• Vaccinations
• Administration of iron chelators
• Intervention in DNA metabolism
• Stem cell therapy

It is rather difficult for doctors to make a prognosis because it depends on various factors. For example, the patient’s overall health is important. Average life expectancy can vary widely, ranging from a few months (high-risk MDS) to several years (low-risk MDS).