Myelodysplastic Syndromes (MDS) is a name given to a family of bone marrow disorders that typically occur in older adults. While not curable, MDS can be managed with certain supportive therapies in order to prevent it from progressing.
Myelodysplastic Syndromes
Myelodysplastic Syndromes (MDS) are a family of diseases that occur in patients whose stem cells don't mature into blood cells or function properly. Some forms of MDS are extremely mild and easy to manage, while others develop into leukemia, which can be life-threatening. MDS is diagnosed through blood and bone marrow testing, after which it is staged by a doctor using the International Prognostic Scoring System. Medical problems that are characteristic to MDS are assigned a score, which in turn gives a patient a predictor as to how well he will fare.
Signs and Symptoms
Early MDS is rarely detected by the patient, who may be asymptomatic in this stage of the disease. However, as MDS progresses, a patient might notice fatigue, shortness of breath, easy bruising or bleeding, tiny red spots just under the skin (petechiae), weight loss and frequent infections. The patient might also be extremely pale due to the presence of anemia.
Supportive Treatment
There is no cure for MDS, so most patients undergo supportive treatment to minimize their symptoms. Many times patients opt for transfusion therapy to increase red blood cell count, thereby reducing fatigue and reducing symptoms of anemia. These treatments can be effective for up to one month at a time. However, in some cases, patients with MDS build up a tolerance to transfusion therapy over time.
The U.S. Food and Drug Administration (FDA) has also approved a short list of drugs that stimulate the production of red blood cells or increasing white blood cells to help prevent infection. Azacitidine and Dacogen can stimulate the development of red and delay progression of the disease into leukemia. Revlimid can help eliminate the need for blood transfusions in patients whose MDS is associated with chromosome abnormality.
Aggressive Treatments
More aggressive approaches to treating patients with severe MDS include chemotherapy and stem cell transplants. However, the latter yields few candidates because of the risk of implanting stem cells in older adults, who are most likely to suffer from MDS. Nonmyeloablative transplantation prior to implantation, rather than chemotherapy, is a new procedure that could make stem cell transplants a more viable option for older adults.
Who Is at Risk?
Risk factors for MDS include age, gender, exposure to carginogens and congenital diseases. People in their 70s and 80s are more likely to develop MDS, with men being more prone to this disease. People with a history of exposure to cancer-causing agents, such as tobacco, may be more at risk for MDS. Certain genetic disorders, such as Fanconi's anemia and Down syndrome, increase the risk of MDS.
Tags: blood cells, Myelodysplastic Syndromes, older adults, bone marrow, cell transplants, into leukemia