MDS, or myelodysplastic syndrome, is a rare type of blood cancer. Also known as “bone marrow failure disorder” MDS is caused by the bone marrow’s inability to produce enough healthy blood cells.
MDS is difficult to diagnose as it does not show significant symptoms in the early stages. Most common in older people, 90% of diagnosed patients are over 60 years old. If left untreated, the MDS life expectancy is on average 5 months.
What is MDS?
The bone marrow naturally produces blood cells that each have different functions;
- White blood cells work as part of the immune system and fight infections
- Red blood cells carry oxygen in the bloodstream
- Platelets help to control bleeding
When the bone marrow cannot produce healthy blood cells for unknown reasons, cells develop abnormally. These unhealthy cells die earlier before getting into the bloodstream. This condition is called Myelodysplastic syndromes, or MDS.
Types of MDS
At least one or more of the three types of blood cells produced in the bone marrow can cause MDS. Accordingly, MDS types are;
- Myelodysplastic syndrome with single lineage dysplasia: It is caused by the abnormal growth of one of the white or red blood cells or platelets cells.
- Myelodysplastic syndrome with multilineage dysplasia: It is caused by the abnormal growth of two or all blood cells.
- Myelodysplastic syndrome associated with isolated del chromosome abnormality: In this MDS type, there is a decrease in the patient’s red blood cells, while a mutation in the cell DNA is observed.
- Myelodysplastic syndrome with ring sideroblasts: Abnormal development occurs in one or more types of blood cells of this type. Iron surpluses called “sideroblasts” are seen in red blood cells in the bone marrow.
- Myelodysplastic syndrome with excess blasts: Abnormal growth is observed in one of the blood cells. Bone marrow contains immature blood cells called “blasts”.
- Myelodysplastic syndrome, unclassifiable: In this syndrome, there is a decrease in the level of one of the blood cells, while an abnormality is observed in the white blood cells or platelets.
MDS symptoms are not detected in the early stages. But as it progresses, symptoms become more apparent and severe. MDS symptoms vary depending on which types of blood cells are affected.
- Abnormality and decrease of Red Blood Cells: The function of red blood cells is to carry oxygen in the bloodstream. In cases where red blood cells are reduced and abnormally reproduced, it cannot fulfill this task. Decreased oxygen in the bloodstream can cause weakness, fatigue and shortness of breath. This condition is defined as “anemia”.
- Abnormality and decrease of White Blood Cells: Since the task of white blood cells is to provide body immunity, the body becomes more vulnerable to infections if it is reduced. The person becomes more easily infected.
- Abnormality and decrease of Platelets: Platelet deficiency makes it difficult to coagulate blood. In this case, bleeding is the most common symptom. Gum bleeding can also be seen.
MDS Life Expectancy
MDS life expectancy depends on the condition, type and progression of the disease. The International Prognostic Scoring System (IPSS-R) categorizes MDS patients into 5 different categories according to their risk. According to this risk classification, MDS survival rate is estimated.
- Very low risk: 8.8 years
- Low risk: 5.3 years
- Intermediate risk: 3 years
- High risk: 1.6 years
- Very high risk: 0.8 years
MDS risk factors are not yet clear. However, researchers think that there are some factors that may cause this disease. Diseases such as Fanconi anemia and Diamond-Blackfan anemia are thought to cause MDS. Another suspected risk factor thought to cause MDS is chemotherapy. It is thought that chemotherapy applied for cancer treatment may cause MDS. Factors such as smoking and advanced age are also thought to contribute to the development of MDS.
MDS Treatment Options
While there are not as many treatments for MDS as for other types of cancer, there are several effective treatment options available.
Chemotherapy is a systematic treatment method used for the treatment of cancer patients. Because it enters the bloodstream to reach many parts of the body, it is a suitable treatment for diseases, such as MDS, that occur in the whole circulation, not only in a single part of the body. It kills abnormal cells in the bone marrow and allows new cells to grow.
- Stem Cell Transplant
Stem cell transplant offers the most effective treatment opportunity for MDS patients, but not every patient is suitable for this treatment. MDS patients who are eligible for this treatment are first administered a high-dose chemotherapy treatment in which the cancer cells are killed. Then new stem cells are transplanted. Stem cell transplant has two types;
Allogeneic stem cell transplant: After the destruction of the bone marrow, blood regulating stem cells are transplanted from a donor. This type of stem cell transplant is one of the most preferred treatments for MDS disease. The success of the treatment depends on the cell match between the donor and the patient.
Autologous stem cell transplant: The reinfusion of the patient’s own healthy stem cells. However, it is not preferred for MDS patients.
- Supportive Treatments
Supportive treatments intend to suppress the symptoms caused by MDS and improve the quality of life. For patients with symptoms of anemia, treatments such as red blood cell transplantation can be used to support red blood cells. Medications can be used to balance the excess iron levels caused by blood transfusions over time. Supplements and antibiotics can be used to boost the weakness of the immune system, caused by white blood cells.
- Drug Therapies
Medications to support treatment can be used for patients with MDS. By using drugs such as azacytidine, drugs that stimulate blood production and prevent the progression of MDS, may be preferred. Treatment can be supplemented with immune-boosting drugs such as lenalidomide.
MDS Clinical Trials
Scientists and institutions continue to work to find new treatments for cancer diseases, improve existing treatments, and reduce symptoms and side effects. MDS is a rare disease that is difficult to investigate due to its late diagnosis in most cases. Therefore, it is very important to support clinical research, to better understand and to develop new treatment methods for the future.
At Massive Bio, we connect you with clinics that develop new treatment methods for your disease, using artificial intelligence and our expert nurse navigators. We help you participate in clinical trials to provide the most effective treatment according to the condition of your disease. You can contact us to learn more about clinical trials and treatment options.