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Myelodysplastic Syndromes (MDS) Causes, Symptoms, and Treatment

What Is Myelodysplastic Syndrome (MDS)?

MDS is a group of disorders that happen when the bone marrow doesn't make enough healthy blood cells.

These flawed cells — or blasts — don't work. Instead, they take up space in the bone marrow or blood, leaving less room for healthy blood cells and platelets to grow.

In the past, doctors called MDS "pre-leukemia" because they progress to acute myeloid leukemia in about one-third of those with it. The American Cancer Society now regards MDS itself as a type of cancer.

MDS tends to affect people over age 60. It's more common in men than in women.

Symptoms rarely appear in the early stages.

Contact Us About Myelodysplastic Syndrome Care

UPMC Hillman Cancer Center has more than 200 cancer experts and 70 locations in Pennsylvania, Ohio, Maryland, and western New York. And as one of the largest community cancer networks in the U.S., we're right in your backyard.

Find a UPMC Hillman Cancer Center doctor or location near you. 

Types of Myelodysplastic Syndromes

Types of MDS include:

  • Refractory anemia. This occurs when there aren't enough red blood cells.
  • Refractory anemia with ringed sideroblasts. This involves a low red blood cell count and too much iron in the red blood cells.
  • Refractory anemia with excess blasts. This involves too many blasts (up to 19% of the cells in the marrow) and not enough red blood cells. It may also affect white blood cells and platelets and turn into acute myeloid leukemia.
  • Refractory anemia with excess blasts in transformation. This involves a large supply of blasts (up to 29% of the cells in the bone marrow).
  • Refractory cytopenia with multilineage dysplasia. This occurs when there aren't enough of at least two types of blood cells. Less than 5% of the cells in the marrow are blasts.
  • Del 5q MDS. This rare form of MDS causes a shortage of red blood cells. Less than 5% of the cells in the bone marrow are blasts.
  • Unclassifiable MDS. This occurs when blast percentages are normal, but there's a shortage of one type of blood cell.

Risk Factors for Myelodysplastic Syndromes

Common MDS risk factors include:

  • Age. People over 60 are at higher risk. It's rare for people under 40 to get MDS.
  • Gender. Men are more prone to MDS than women.
  • Smoking. Smoking increases the risk of MDS.
  • Cancer treatment. Chemotherapy for a different type of cancer — or another blood cancer — can lead to MDS. Risk increases when you combine chemo with radiation.
  • Environment. Exposure to radiation and benzene increase the risk.

You're also at an increased risk of MDS if you have certain genetic diseases such as:

  • Diamond Blackfan anemia.
  • Familial platelet disorder.
  • Fanconi anemia.
  • Severe congenital neutropenia.
  • Shwachman-Diamond syndrome.

How Do Doctors Diagnose Myelodysplastic Syndromes?

People with MDS often have low red blood cell counts. They may also lack enough white blood cells and platelets.

Blood tests can detect any issues with your blood counts, but you'll need a bone marrow biopsy to confirm an MDS diagnosis.

If you've had chemo treatment in the past, your risk of MDS is higher. You should see your doctor for routine follow-up exams and blood tests.

Myelodysplastic Syndrome Treatment Options

Often, the goal of MDS treatment is to slow the progression of the disease. There's not always a cure.

Your treatment will depend on factors such as:

  • The type of MDS you have.
  • Your age.
  • Your overall health.

If your MDS symptoms don't bother you, your doctor may opt to delay treatment. But they will want to see you for regular testing to keep an eye on your disease.

A stem cell or bone marrow transplant is the only cure for MDS. But it's not for everyone because it has a high risk of complications.

Doctors tend to reserve this treatment for younger people in good health that have a matching bone marrow donor.

If a stem cell transplant isn't an option, doctors may use other treatments to:

  • Slow MDS from progressing.
  • Treat or prevent MDS symptoms and complications.
  • Help you live a better quality of life.

Your doctor may suggest:

  • Chemo for people with lower-risk MDS to help control it. Chemo may be too toxic for people who are elderly or have other health problems.
  • Blood cell growth factors. Hormone-like substances that help bone marrow make new blood cells.
  • Red blood cell transfusions to combat anemia.
  • Antibiotics to treat suspected bacterial infections.
  • Platelet transfusions to treat bleeding or bruising from a shortage of platelets.
  • Chelating agents to help the body get rid of excess iron from blood transfusions.

If one treatment doesn't work, your doctor may try another.

They may also suggest you take part in a clinical trial of new MDS drugs and treatments.

MDS prognosis

Prognosis depends on the type of syndrome and how well you respond to treatment.

Why Choose UPMC for MDS Care?

At the Mario Lemieux Center for Blood Cancers at UPMC Hillman Cancer Center:

Cancer care close to home

UPMC Hillman Cancer Center has more than 200 cancer experts and 70 locations in Pennsylvania, Ohio, Maryland, and western New York. And as one of the largest community cancer networks in the U.S., we're right in your backyard.

Find a UPMC Hillman Cancer Center doctor or location near you.