Dr Su Wai Maung MD, MBBS, MRCP(UK), FRCPI, FRCPATH
Consultant Haematologist, Mater Misericordiae University Hospital & Secretary/Treasurer, Haemotology Association of Ireland
Myelodysplastic syndrome (MDS) is a form of blood cancer due to bone marrow failure where the body no longer makes enough healthy blood cells.
The result of the body not making enough healthy blood cells is having low blood counts such as anaemia, low white blood cells and low platelet count. One in three patients with MDS may progress to acute, which is a more severe form of blood cancer.
Potential triggers of MDS
MDS is primarily a disease of older persons (age 65 and over) but also can be found in younger people. The exact cause for MDS is yet unknown. However, potential triggers are identified such as previous treatment with radiation or chemotherapy and environmental factors such as long-term exposure to chemicals like benzene.
While many patients may not experience any symptoms at the time of diagnosis, some patients with MDS may have symptoms related to having low blood counts:
- Low red blood cells (anaemia) which causes tiredness, lack of energy, poor exercise tolerance.
- Low white blood cells which causes recurrent infections.
- Low platelet levels which causes abnormal bruising or bleeding.
One in three patients with MDS may progress to acute, which is a more severe form of blood cancer.
Advances in diagnostic testing
The first step in diagnosing MDS is to check the blood count and examination of the patient’s blood cells under the microscope to detect abnormal features suggestive of underlying MDS. Low blood count levels may also be due to other causes such as medications, infections, low levels of vitamins and nutrients, immune disorders etc. It is important to check other possible factors for low blood counts first before confirming the diagnosis with specific tests for MDS such as bone marrow examination.
Advances in diagnostic tests enable better understanding of the disease biology and provides useful information for choosing appropriate treatment options. Studying chromosomal abnormalities and molecular changes associated with MDS have now become standard of care.
Finding best treatment options
Treatment of MDS depends on how low your blood count is and the severity of bone marrow failure. Some patients may not require any treatment but some requires transfusion of red blood cells and platelets or more specific treatment for MDS. MDS-specific treatment ranges from growth factors to improve blood counts, intensive or non-intensive chemotherapy and stem cell transplant.
Many patients who do not require treatment at the time of diagnosis will be closely monitored on regular basis by haematology team.
New treatments are tested and evaluated through clinical trials and many trials are ongoing for MDS patients worldwide. In Ireland, a new clinical trial using a monoclonal antibody in combination with a standard treatment will be recruiting patients soon.