Myelodysplastic Syndrome : Types, Symptoms, Risk Factors, Treatments

Myelodysplastic Syndromes are a rare condition in which the blood cells are  partially formed or incorrectly formed . It is a type of  bone marrow failure disorder as the body becomes incapable of making healthy blood cells. It is more common in people aged 65 and above , though it can occur in younger people and children. The disorder ranges from mild to severe and differs from one person to another based on its type. Myelodysplastic syndrome is often considered  as a form of cancer. Some of the patients with myelodysplastic syndromes can also develop other blood cancers called leukemias.

In the initial stages of myelodysplastic syndrome,symptoms may be mild. However, after a few weeks, you may experience shortness of breath and fatigue. There are plenty of options that can help treat the disorder by controlling the symptoms and preventing any complications that may affect life quality. Chemotherapy and stem cell transplantation may even cure the patient.

About myelodysplastic syndrome

Bones support the body and act as a framework . The bone marrow, a sponge-like material, makes the white blood cells, red blood cells, and platelets. The bone marrow functions as a factory which produces three kinds of blood cells, namely red blood cells, white blood cells and the platelets. Healthy bone marrow makes immature blood cells called progenitor cells, stem cells, or blasts, which normally develop into mature, fully functional red and white blood cells, including platelets. In myelodysplastic syndrome or MDS, these stem cells may not mature and may also accumulate in the bone marrow, or they may have a reduced life span, resulting in fewer than normal mature blood cells in the circulation.

Types of  myelodysplastic syndromes

Based on the types of cells, there are different types of myelodysplastic syndromes.

1. Myelodysplastic syndrome with multilineage dysplasia (MDS-MLD)
   Around two or three different types of blood cells are abnormal. It is the most common form of myelodysplastic syndrome.
2. Myelodysplastic syndrome with unilinear or single dysplasia (MDS-SLD)
   Here, one type of blood cells (white or  red blood cells or platelets) is abnormal or inadequate.
3. Myelodysplastic syndrome with ring sideroblasts (MDS-RS): It is a type of syndrome in which the red cells have a ring of additional iron, termed ring sideroblasts.
4. Myelodysplastic syndrome linked to an isolated del chromosome abnormality (5q): This type manifests with low red blood cells with a particular DNA mutation. It is not a common syndrome, and there could be a deletion of chromosome 5q.
5. Myelodysplastic syndrome with excess blasts (MDS-EB): The syndrome is of two types, type 1 and type 2. In both cases, the cell count could be low or abnormal. The cells found in the bone marrow appear to be immature, hence the name blasts.

6.       Myelodysplastic syndrome unclassifiable (MDS-U)

 In this uncommon syndrome, there are decreased numbers of one of the three kinds of mature blood cells, and either the platelets or white blood cells look abnormal under a microscope.

Symptoms of myelodysplastic syndrome

In the early stages, the myelodysplastic syndrome may rarely show symptoms and signs. However, in later stages, you may experience the following:

• Shortness of breath
• Exhaustion
• Fever
• Pain in the bones
• Unusual bleeding or bruising due to low platelet count
• Pallor or unusual paleness due to anemia or low red blood cells
• Infections due to leukopenia or low white blood cell counts
• Tiny red spots under the skin due to petechiae or bleeding

When to see a doctor?

If you observe any of the symptoms , it is advised that you visit the doctor.  The condition is diagnosed through blood tests and a bone marrow examination. Based on the results of the tests, doctors would suggest medications and treatments for better health.

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 Causes related to myelodysplastic syndrome

In most cases, the cause of myelodysplastic syndrome is  not known. The syndrome usually occurs when the process of bone marrow producing new and healthy blood cells is disrupted. However, some of the major causes that could result in the occurrence of myelodysplastic syndromes are:

• Exposure to toxic chemicals such as heavy metals, benzene, tobacco, and pesticides
• Cancer treatments, including radiation or chemotherapy

Risk factors for myelodysplastic syndrome

Some factors are responsible for increasing the risks of myelodysplastic syndrome.

• The risk is more in older people who are above 60 years of age.
• If a person has been exposed to chemicals, either by working in factories or living near the factory areas
• Excessive smoking could also increase the risks of MDS.
• Some treatments, such as radiation therapy or chemotherapy to treat cancer

Are there any complications related to myelodysplastic syndrome

In case the disorder is not treated on time, there may be severe consequences. Some of them include

• Infections: Low counts of blood cells or abnormal blood cells could lead to severe recurrent infections .
• Bleeding: When the platelet count is less, there could be excessive bleeding.
• Risk of serious diseases: there could be a risk of developing leukemia or blood cell cancer.
• Anemia: You could experience fatigue if the red blood cell count keeps  decreasing with time.

Treatments for myelodysplastic syndrome

1.  Medications: Treatment for myelodysplastic syndromes might include medications that:

• Increase the number of blood cells your body produces. Referred to as growth factors, these medicines are artificial versions of substances found naturally in your bone marrow.

Some growth factors like darbepoetin alfa, or epoetin alfa, reduce the need for blood transfusions by increasing the red blood cells. Others, like filgrastim  may help prevent infections by increasing the white blood cells .

• Stimulate blood cells to mature. Medicines like azacytidine and decitabine may improve quality of life of those with some myelodysplastic syndromes and decrease the risk of acute myelogenous leukemia.
• Help individuals with a some genetic abnormality. If your myelodysplastic syndrome is linked to a gene mutation called isolated del(5q), your physician may recommend lenalidomide .
• Treat infections. If your condition leads to infections, you may be treated with antibiotics.

2.  Blood transfusions: When there is a lack of blood cells in the body, a doctor may order  a blood transfusion to solve the problem.

3.  Stem transplant or bone marrow transplant: The doctor may give you Chemotherapy in high doses that help destroy the stem cells and replace them with healthy stem cells from the donor.

Frequently Answered Questions

1.       How fast does the myelodysplastic syndrome develop?

It depends on the type of syndrome and the health of the person. While  MDS could rapidly develop in months in some people, it could take years .

2.       Is MDS inherited in families?

Not really. It is not a hereditary condition, but it can rarely pass from parent to child. In some cases, some genetic factors play a role in increasing the risk of developing Myelodysplastic Syndrome.

3.       What should you eat when you have Myelodysplastic Syndrome?

You can eat  healthy food, including fruits, vegetables, legumes, and whole grains with fiber, protein, minerals, and vitamins. A healthy diet is recommended for patients with MDS.

Conclusion

In most cases, one can treat MDS. Nevertheless, once you notice any signs and symptoms, you should visit your doctor and get examined. Do not neglect any health condition and have a positive attitude to fight the disorder.