Blood has a number of important functions in the body. It carries oxygen and nutrients to cells that depend on a constant supply of oxygen and nutrients to function normally and remain healthy (and it also carries waste products away from those cells). Blood delivers the immune cells that fight infections and repair damage. Blood contains components that stop bleeding when a blood vessel is injured.
The blood cells that carry out these different functions are produced in the bone marrow, the soft, spongy tissue found at the core of many bones throughout the body. More specifically, blood cells are produced in red bone marrow, which is found in flat bones, like the sternum and pelvis.
Myelodysplastic syndromes (MDS) are a group of disorders that disrupt the bone marrow’s ability to produce healthy blood cells. MDS are considered a type of cancer and are usually diagnosed in people over the age of 65.
What are the symptoms of MDS?
Red bone marrow produces three main types of blood cells—red blood cells, white blood cells, and platelets:
- Red blood cells carry oxygen and nutrients to cells throughout the body.
- White blood cells are part of the immune system and help the body fight infections.
- Platelets clot together to stop bleeding when a blood vessel is injured.
All three types of blood cells begin as immature blood cells (called blood stem cells). When a person has MDS, the bone marrow produces abnormal blood stem cells, which do not mature. These immature blood cells are called blasts. This results in high levels of abnormal blood cells and low levels of healthy blood cells.
Symptoms can vary depending on the type of blood cells that are impacted.
- Low levels of red blood cells result in anemia, with symptoms that include fatigue, dizziness, pale complexion, headaches, increased heart rate, and feeling out of breath.
- Low levels of white blood cells lower a person’s immunity. A person may experience frequent infections, such as bacterial or fungal infections.
- Low levels of platelets cause a person to bruise and/or bleed easily and/or excessively. For example: nose bleeds, bleeding gums, increased menstrual blood loss.
Diagnosing MDS typically involves blood tests to measure the amounts of different blood cells in the body (complete blood count) as well as a bone marrow biopsy, a test that involves taking a sample of bone marrow that is then sent to a lab for examination and testing.
MDS is a different condition for different people. Some people experience mild symptoms and other people experience severe symptoms.
What is lower-risk and higher-risk MDS?
MDS is a disease of the bone marrow and blood, which are spread throughout the body. The staging systems used for many other cancers—which account for tumor size and how far a cancer has spread—do not translate well to this type of disease.
Instead, healthcare providers use prognostic scoring systems that places MDS into lower-risk or higher-risk groups. This helps guide treatment recommendations. Lower risk typically means a less intense treatment approach is recommended. Higher risk typically means a more aggressive approach is recommended.
Prognostic scoring systems are complex. These systems are also evolving, as medical researchers continue to learn more about the different changes to genes and chromosomes that occur with MDS, and how these affect prognosis and treatment.
Understanding your prognosis is important. Your healthcare team will be your best source of information about your prognosis. Some questions to ask your healthcare provider include:
- What is my prognosis? What risk group am I in?
- What prognostic scoring system is being used? What factors does this scoring system take into account?
- What does this information mean for treatment?
Other factors, such as your age, your symptoms, your overall health, and the results of your blood work are also important factors to consider.
Sources: Dean L. Bethesda. Blood Groups and Red C... + 10
- Dean L. Bethesda. Blood Groups and Red Cell Antigens [Internet]. National Center for Biotechnology Information (US), 2005.
- American Society of Hematology. Blood Basics.
- NCI Dictionary of Cancer Terms. Bone Marrow.
- Moffitt Cancer Center. What Is Bone Marrow?
- National Cancer Institute. Myelodysplastic Syndromes Treatment (PDQ)–Patient Version.
- Jennifer L. Dotson and Yehuda Lebowicz. Myelodysplastic Syndrome. StatPearls. July 18, 2022.
- American Red Cross. What Do Blood Cells Do?
- NCI Dictionary of Cancer Terms. Blood stem cell.
- National Organization for Rare Disorders. Myelodysplastic Syndromes.
- American Cancer Society. Myelodysplastic Syndrome (MDS) Prognostic Scores (Risk Groups).
- Amy E. DeZern and Peter L. Greenberg. The trajectory of prognostication and risk stratification for patients with myelodysplastic syndromes. Blood. Vol. 142, No. 26.
