From the Guidelines
MDS stands for Myelodysplastic Syndromes, a group of blood disorders characterized by ineffective production of blood cells in the bone marrow. These disorders are diagnosed based on multiple factors, including clinical data, peripheral blood and bone marrow morphology, fluorescence in situ hybridization, cytogenetics, flow cytometry, and next-generation sequencing myeloid mutation panels 1. The major clinical morbidities associated with MDS are cytopenia-associated complications and the potential for MDS to evolve into acute myeloid leukemia (AML) 1.
Key Characteristics of MDS
- MDS represents myeloid clonal hematopathies with a relatively heterogeneous spectrum of presentation 1
- 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 management of MDS is complicated by the generally advanced age of the patients (median age, 77 years), the presence of nonhematologic comorbidities, and the relative inability of older patients to tolerate certain intensive forms of therapy 1
Treatment Approaches
- Treatment approaches vary based on disease severity, ranging from supportive care with blood transfusions and growth factors to more intensive therapies like hypomethylating agents (azacitidine, decitabine) or stem cell transplantation in eligible patients
- The choice of treatment is influenced by factors such as the patient's age, overall health, and the specific characteristics of their MDS 1
From the Research
Definition of MDS
- MDS stands for Myelodysplastic Syndromes, which are clonal hematopoietic malignancies characterized by morphologic bone marrow dysplasia along with anemia, neutropenia, or thrombocytopenia 2.
- Myelodysplastic neoplasms (MDS) are formerly known as myelodysplastic syndromes, and are associated with an increased risk of acute myeloid leukemia (AML) 2.
Characteristics of MDS
- MDS are characterized by reduced numbers of peripheral blood cells, an increased risk of acute myeloid leukemia transformation, and reduced survival 2.
- The median age at diagnosis is approximately 70 years, and the yearly incidence rate increases to 25 per 100 000 in people aged 65 years and older 2.
- Risk factors associated with MDS include older age and prior exposures to toxins such as chemotherapy or radiation therapy 2.
Diagnosis and Treatment of MDS
- MDS can be diagnosed using a combination of peripheral blood smear, bone marrow aspirate morphology, and cytogenetic analysis 3.
- The treatment of MDS depends on the risk stratification of the patient, with lower-risk patients receiving supportive care and higher-risk patients receiving hypomethylating agents or hematopoietic cell transplantation 4.
- Erythropoiesis-stimulating agents, such as recombinant humanized erythropoietin or darbepoetin alfa, can improve anemia in 15% to 40% of patients with lower-risk MDS 2.