From the Guidelines
Myelodysplastic syndrome can potentially elevate D-dimer levels due to its complex pathophysiology and associated coagulation abnormalities. The relationship between myelodysplastic syndrome (MDS) and elevated D-dimer levels is multifaceted, involving the release of procoagulant substances from abnormal cells, increased cytokine production, and endothelial dysfunction, as noted in the management of MDS 1. MDS is a group of bone marrow disorders characterized by ineffective hematopoiesis and dysplastic changes in blood cells, which can lead to various coagulation abnormalities.
Some key points to consider in the context of MDS and D-dimer elevation include:
- The incidence of MDS in the general population is approximately 4.5 per 100,000 people per year, with a higher incidence in older adults 1
- MDS patients often have comorbidities or complications such as infections or thrombotic events that can independently raise D-dimer levels
- Elevated D-dimer levels in MDS patients should not be dismissed as merely a disease manifestation, as it could indicate serious complications like disseminated intravascular coagulation (DIC), venous thromboembolism, or disease progression
- Clinicians should interpret elevated D-dimer levels in the context of the patient's overall clinical picture, considering other coagulation parameters and clinical symptoms to determine appropriate management, as outlined in the nccn guidelines® insights: myelodysplastic syndromes, version 2.2025 1.
Given the potential for MDS to elevate D-dimer levels and the importance of considering the patient's overall clinical picture, it is essential to monitor D-dimer levels and other coagulation parameters in MDS patients to promptly identify and manage any complications that may arise.
From the Research
Myelodysplastic Syndrome and D-Dimer Levels
- Myelodysplastic syndrome (MDS) is a group of disorders caused by poorly formed or dysfunctional blood cells, which can lead to various complications, including bleeding and thrombosis.
- The relationship between MDS and D-dimer levels is not extensively studied, but there is some evidence to suggest that MDS may be associated with elevated D-dimer levels in certain cases.
- A study published in 1999 2 reported a case of MDS with leukemic spread of mast cells, which presented with hyperfibrinolysis, hypofibrinogenemia, and an elevated D-dimer level.
- However, this finding is not consistently reported in other studies, and the relationship between MDS and D-dimer levels remains unclear.
- Other studies have focused on the diagnosis, prognosis, and treatment of MDS, but have not specifically addressed the issue of D-dimer levels 3, 4, 5, 6.
- Further research is needed to fully understand the relationship between MDS and D-dimer levels, and to determine whether elevated D-dimer levels are a common feature of MDS or a rare complication.
Key Findings
- MDS is a heterogeneous group of disorders characterized by dysplasia and ineffective hematopoiesis.
- The diagnosis of MDS is based on morphological evidence of dysplasia and other diagnostic criteria.
- Treatment options for MDS include supportive care, erythropoiesis-stimulating agents, hypomethylating agents, and hematopoietic cell transplantation.
- Elevated D-dimer levels have been reported in a single case of MDS with leukemic spread of mast cells, but the significance of this finding is unclear.