What is Myelodysplastic Syndrome (MDS) and what does it affect?

From the Guidelines

Myelodysplastic Syndrome (MDS) is a group of blood disorders characterized by ineffective production of blood cells in the bone marrow, primarily affecting the bone marrow's ability to produce healthy blood cells, leading to low blood counts (cytopenias) including anemia, neutropenia, and thrombocytopenia. This condition most commonly affects older adults, with the average age at diagnosis being around 70 years 1. The severity of MDS varies widely, from mild cases requiring minimal treatment to severe forms that can progress to acute myeloid leukemia (AML), a type of blood cancer.

Key Characteristics of MDS

• MDS occurs when the blood-forming stem cells in the bone marrow become abnormal and produce defective cells that often die prematurely 1.
• The underlying cause involves genetic mutations in the bone marrow stem cells, which can occur spontaneously or result from previous exposure to chemotherapy, radiation, or certain chemicals.
• Symptoms typically reflect the affected blood cell lines and may include fatigue, frequent infections, easy bruising, and abnormal bleeding.

Impact of MDS on Quality of Life

• The management of MDS is complicated by the generally advanced age of the patients (median age, 77 years), and the presence of nonhematologic comorbidities commonly seen in this cohort 1.
• Treatment approaches depend on the specific MDS subtype, risk category, age, and overall health of the patient, ranging from supportive care to stem cell transplantation in eligible candidates.
• Preserving the MDS patient’s quality of life (QoL) is the main goal of transfusion therapy, and managing the long-term efficacy of transfusion therapy in relation to their QoL is essential 1.

Prognosis and Treatment

• The incidence of MDS in the general population is approximately 4.5 per 100,000 people per year, with a significant increase in incidence among individuals aged 70 and 79 years, and further increases to 55.4 per 100,000 in individuals aged ≥80 years 1.
• The development of secondary iron overload in MDS patients requiring regular red cell transfusions significantly worsens their survival, and patients with MDS and regular transfusion need should be considered for chelation therapy 1.

From the FDA Drug Label

REBLOZYL is a prescription medicine used to treat anemia (low red blood cells) in adults with: • myelodysplastic syndromes who may need regular RBC transfusions and have never received an erythropoiesis stimulating agent (ESA).

Myelodysplastic syndromes (MDS) meeting French-American-British (FAB) classification criteria and International Prognostic Scoring System (IPSS) High-Risk, Intermediate-2 and Intermediate-1 prognostic scores

Myelodysplastic Syndrome (MDS) is a condition that affects the blood and bone marrow, leading to anemia (low red blood cells) and potentially other blood-related problems. It can affect the production of healthy blood cells, including red blood cells, white blood cells, and platelets.

• Key points about MDS:
  • Affects blood and bone marrow
  • Leads to anemia and potentially other blood-related problems
  • Impacts production of healthy blood cells 2

From the Research

What is Myelodysplastic Syndrome (MDS)

Myelodysplastic Syndrome (MDS) is a group of clonal hematopoietic malignancies characterized by morphologic bone marrow dysplasia, along with anemia, neutropenia, or thrombocytopenia 3. It is also known as myelodysplastic neoplasms. MDS represents a collection of stem cell disorders that impair hematopoiesis, resulting in low peripheral blood counts 4.

Effects of MDS

MDS affects the production of blood cells, leading to:

• Anemia (low red blood cell count)
• Neutropenia (low white blood cell count)
• Thrombocytopenia (low platelet count) These conditions can cause symptoms such as fatigue, weakness, bleeding, and increased risk of infection 3, 4.

Risk Factors and Incidence

The risk factors associated with MDS include:

• Older age
• Prior exposures to toxins such as chemotherapy or radiation therapy
• MDS is more common in men compared to women, with yearly incidence rates of approximately 5.4 vs 2.9 per 100,000 3. The yearly incidence of MDS is approximately 4 per 100,000 people in the United States, with a higher incidence rate among patients with advanced age 3.

Prognosis and Treatment

The prognosis for MDS varies depending on the subtype and risk factors. Patients with lower-risk MDS have a median survival of approximately 3 to 10 years, while those with higher-risk disease have a median survival of less than 3 years 3. Treatment options for MDS include:

• Erythropoiesis-stimulating agents for anemia
• Hypomethylating agents such as azacitidine or decitabine for higher-risk MDS
• Hematopoietic cell transplantation, which is the only potential cure for MDS 3, 4, 5.