Myelodysplastic Syndromes (MDS) – Myelodysplastic Syndrome – Updated 2020

What is myelodysplastic syndromes (MDS)?

Myelodysplastic syndromes, also known as MDS, are composed of various blood disorders that usually appear in older adults. MDS are clonal disorders affecting one or more blood cell lines, resulting in multiple types of cytopenia (a reduced blood cell count in different cell lines). Since myelodysplastic syndromes are composed of a heterogeneous group of diseases, the bone marrow can be either aplastic (not having many cells) or hypercellular (having too many cells). What is true in most MDS is that cells in the bone marrow share aberrant features and inadequate maturation, and this is why blood cell production becomes impaired.

Depending on the stage and type of disease, patients may experience different signs and symptoms and various cytogenic events. Genetics are variable, but the clinical presentation shares some features, especially anemia and thrombocytopenia. Thus, the workup is similar, and the differential diagnosis is sometimes difficult to make if we don’t have bone marrow biopsies.

This disease was initially considered an independent disease, and it was only included as a neoplastic disease after 2001. Back in 1976, the incidence was 1500 cases every year. Now, the myelodysplastic syndrome is diagnosed in up to 55,000 new patients every year. This rise is apparently due to improved diagnostic tests, an increase in the lifespan and the population of older adults.

86% of cases are diagnosed in older adults, the median age of diagnosis is 76 years old, and it is more common in males. However, there are cases of myelodysplastic syndrome in children and females, especially if they have risk factors.