From the Research
There is an association between rheumatoid arthritis (RA) and myelodysplastic syndromes (MDS), with patients with RA having a higher risk of developing MDS due to factors such as dysregulation of the immune system and cytotoxic effects of certain medications. The association between RA and MDS is complex and multifactorial. Some studies suggest that the risk of developing MDS is increased in patients with RA, particularly those with longstanding disease or more severe disease activity 1, 2. The exact mechanisms underlying this association are not fully understood, but it is thought that dysregulation of the immune system, abnormal cytokine production, and chronic inflammation may contribute to bone marrow dysfunction and increase the risk of developing MDS. Some medications used to treat RA, such as disease-modifying antirheumatic drugs (DMARDs) like methotrexate, cyclophosphamide, and azathioprine, may also increase the risk of developing MDS due to their cytotoxic effects on bone marrow cells 3, 4. Key factors that contribute to the association between RA and MDS include:
- Dysregulation of the immune system
- Abnormal cytokine production and chronic inflammation
- Cytotoxic effects of certain medications, such as DMARDs
- Longstanding disease or more severe disease activity Clinicians should be aware of the potential association between RA and MDS and maintain vigilance for signs of MDS, such as unexplained cytopenias, recurrent infections, easy bruising, and fatigue, particularly in patients on long-term immunosuppressive therapy. Regular monitoring of complete blood counts is important for early detection of potential bone marrow abnormalities in these patients 2.