Are your blood cells not forming properly? Let's learn about Myelodysplastic Syndrome (MDS)!

Do you feel tired and exhausted all the time? Do you sometimes find it hard to breathe even after doing a little work? Or do you notice bruises and bleeding everywhere on your body? Even though you think these are normal things, sometimes there may be a reason behind this that you should be a little concerned about. Today we are going to talk about one such condition, which is myelodysplastic syndrome.

What is myelodysplastic syndrome (MDS)?

Now let's see what this Myelodysplastic Syndrome (MDS) is. Some people also call it Myelodysplasia. More recently, it is also called Myelodysplastic Neoplasm. Simply put, it is a type of cancer . But what happens in this is that the basic cells that make blood in our body – we call them (hematopoietic stem cells) – do not mature properly, that is, they do not grow properly. These cells are located in our bone marrow. So the problem begins when these basic cells do not develop properly and become healthy red blood cells, white blood cells, and platelets.

When your body doesn't have enough healthy blood cells, you can develop serious conditions like anemia. You can also get infections more often and bleed more often. In some people, MDS can get worse and develop into a cancer called acute myeloid leukemia (AML) .

This condition, called MDS, is very rare . In the United States, it affects about four people in every 100,000 people each year. If you are diagnosed with MDS, your doctors will try to slow the progression of the disease, control your symptoms, and treat any complications that may arise.

What types of MDS are there?

Doctors divide this MDS condition into several types. They look at the results of several tests. Let's take a look at what those tests look for:

• Healthy red and white blood cells and platelet count: When your red blood cells are low, we call it anemia. You may feel very tired and short of breath.
• Immature blood cells, or blasts: These blasts are like immature blood cells. They take up too much space in the bone marrow, making it harder for healthy blood cells to form. If you don't have enough healthy white blood cells, you may get infections more often. And if you don't have enough healthy platelets, it can be hard to stop bleeding.
• Sideroblasts:These are immature red blood cells. What's special about them is that instead of using iron to make hemoglobin, they store iron. You know, hemoglobin is a protein that helps our red blood cells carry oxygen throughout the body. Iron is essential for this. So, if pathologists see these sideroblasts, it means that your hemoglobin isn't working properly.
• Chromosomal abnormalities: Chromosomes are the parts of our cells that contain genes. Genes are made up of DNA. If there are abnormalities in these chromosomes, it means that something has affected your DNA and caused changes in the chromosomes in your blood cells.

What are the symptoms of myelodysplastic syndrome?

Remember, sometimes you may have MDS without showing any symptoms. In such cases, the condition is discovered incidentally during a routine blood test. The main symptom that many people experience is a low red blood cell count, or anemia. However, the symptoms of anemia and other symptoms of MDS can be similar to those of other, less serious conditions.

Therefore, if you notice any of the changes below, especially if they don't go away after a few weeks, be sure to see a doctor.

• If you feel like you can't breathe (we call this dyspnea).
• If you feel weak or extremely tired , and the fatigue does not subside even after getting plenty of rest.
• If you notice that your skin is paler than usual. Perhaps if you have dark skin, the doctor will check to see if there is any loss of color inside your lower eyelids, inside your mouth, and inside your nose.
• If you bruise or bleed more easily than usual.
• If you notice tiny, pin-point red dots on your skin, these could be petechiae, tiny blood vessels under the skin.
• If you often get infections with fever .

What causes MDS?

There seem to be two main ways to develop MDS. One is by engaging in certain activities that increase the risk of developing this syndrome. The other is by inheriting certain genetic conditions.

Activities that can be associated with MDS

• Having received chemotherapy or radiation therapy for a previous cancer. Doctors call this therapy-related MDS (tMDS). Typically, symptoms of tMDS appear about five to seven years after treatment.
• Exposure to certain carcinogens, including tobacco smoke, pesticides, and solvents like benzene.
• Exposure to heavy metals like mercury or lead.

Hereditary conditions that may be associated with MDS

Between 4% and 15% of people with the condition have inherited genetic conditions that increase their risk of developing the disease. Such conditions include:

• Fanconi anemia: This is a rare genetic condition in which your bone marrow does not produce enough healthy blood cells.
• Dyskeratosis congenita: This is another rare genetic condition. Here, too, your bone marrow doesn't produce enough healthy blood cells.
• Diamond-Blackfan anemia: This is a rare blood disorder in which your bone marrow does not produce enough red blood cells.

How is myelodysplastic syndrome diagnosed?

Doctors follow several steps to diagnose this MDS condition:

• Complete Blood Count (CBC) and differential test: A blood sample is taken from you and your red and white blood cells are analyzed. It also counts the number of each type of white blood cell.
• Peripheral blood smear: This checks for changes in the size, type, shape, and size of the blood cells in your blood sample, as well as whether your red blood cells have too much iron.
• Cytogenetic analysis: A medical pathologist looks at a blood sample under a microscope to see if there are any changes in the chromosomes of your blood cells.
• Bone marrow biopsy: To perform this test, the doctor inserts a hollow needle into your hip bone, takes a sample of bone marrow, blood, and bone, and examines it under a microscope.

What are the stages of myelodysplastic syndrome?

Doctors divide the condition into stages based on the risk of the syndrome developing into acute myeloid leukemia (AML). They use a risk-scoring system called the International Prognostic Scoring System (IPSS) . Here are some things doctors consider:

• Whether you have any signs of anemia, bleeding, or infection.
• You are at risk of developing leukemia.
• Some changes in your chromosomes.
• Whether you developed MDS after receiving chemotherapy or radiation therapy for cancer.
• Your age and general health.

How is myelodysplastic syndrome treated?

Doctors consider several things when planning treatment for MDS:

• The type of MDS you have.
• Whether you have conditions like anemia, bleeding, or infections due to MDS.
• Whether you developed MDS after receiving chemotherapy or radiation therapy for cancer.
• your age.
• Your general health.

Treatment for myelodysplastic syndrome may include supportive care and treatments that destroy unhealthy blood cells .

Supportive Care

This may include:

• Blood transfusion or blood donation: If you have anemia, you can have a red blood cell transfusion. If you have problems with bleeding, you can have a platelet transfusion.
• Erythropoiesis-stimulating agents (ESA): This treatment increases your level of mature red blood cells.
• Antibiotics: MDS can affect your white blood cells, increasing your risk of developing infections. Therefore, antibiotics may be given.

Treatments to eliminate unhealthy blood cells

This may include:

• Chemotherapy: The same types of chemotherapy used for acute myeloid leukemia (AML) can be used for this.
• Immunosuppressive therapy: This treatment is used for some subtypes of MDS. This treatment suppresses the overactive immune system and can help reduce the need for blood transfusions.
• Stem cell transplant: This involves replacing your own blood-forming cells with stem cells, either from you or a donor. These stem cells are taken from your blood or bone marrow. These cells are kept in a freezer while you are receiving chemotherapy, then thawed and given back into your body through an intravenous infusion. These cells are then allowed to grow in your body and make new blood cells.

Each of these treatments can have different side effects and complications. When you are considering treatment options, it is very important to ask your doctor about the side effects and complications of each method.

People with myelodysplasia may benefit from palliative care . This care can help manage the symptoms of MDS and the side effects of treatment. And importantly, it can help manage the stress of living with such a chronic disease.

Can myelodysplastic syndrome be cured?

The only way to completely cure MDS is with a successful stem cell transplant . Unfortunately, not everyone can have this treatment. Ask your doctor if this type of transplant is right for you and if it is an option you should consider.

What is the life expectancy of someone with myelodysplastic syndrome?

Myelodysplastic syndrome is a serious health problem that can cause life-threatening conditions.Also, this is a very complex health issue, and everyone is affected differently. Your doctor is the best source of information about your individual situation and the prognosis.

Can myelodysplastic syndrome be prevented?

No, but understanding the risk factors for MDS can help doctors diagnose and treat MDS early. Myelodysplastic syndrome is associated with chemotherapy and radiation therapy, as well as exposure to certain chemicals and heavy metals. Talk to your doctor about your medical history and any close, long-term exposures to chemicals and heavy metals. They can help you assess your personal risk.

How do I take care of myself?

MDS affects everyone differently. Some people have MDS but have no symptoms. If this is the case for you, your doctor may recommend blood tests every three months to monitor changes in your blood stem cells. If you have MDS and are receiving supportive care, such as blood transfusions, you may need additional treatments to reduce the frequency of blood transfusions. Here are some steps you can take to support your treatment:

• If you use tobacco products (including smoking and vaping), try to quit. Ask your doctor about tobacco cessation programs.
• Maintain a healthy weight for yourself.
• Find physical activities you enjoy and do them as often as possible.
• Remember that MDS is a chronic disease, and doctors can treat it but not cure it. Not everyone will understand what you're going through. Talking to others who have been through the same things as you can help. Your medical team can help you find programs and resources like these.

Although MDS is a chronic disease, it does not mean that you have to live without hope. There are treatments that can help control the condition.

When should I go to the emergency room?

Myelodysplastic syndrome can cause anemia, bleeding problems, and infections. You should definitely go to the emergency room if you have:

• If you have a fever of 38.3 degrees Celsius (100.4 degrees Fahrenheit) or higher, a fever is a sign that you may have an infection.
• If you are bleeding uncontrollably.

What questions should I ask my doctor?

Because myelodysplastic syndrome is a rare disease, you may have many questions about it. Here are some questions you can ask your doctor:

• Is MDS a cancer?
• How does MDS affect me?
• Will my MDS cause serious health problems? If so, what kind?
• I have no symptoms. What can I do to delay the development of MDS-related conditions?

Final Take-Home Message

If you have myelodysplastic syndrome (MDS), it is a type of cancer that is a chronic disease. No disease is easy, but living with a chronic disease means dealing with the emotional impact it can have. But living with MDS doesn’t mean you have to give up hope. There are treatments that can help control MDS. You may be eligible for a clinical trial that is looking for new treatments for myelodysplastic syndrome. There are also things you can do for yourself. Ask your doctor about lifestyle changes, such as eating well and exercising. These things can help you stay as healthy as possible. Never be afraid, and don’t suffer alone. Talk to your doctor about everything, and get the help you need.

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