Our blood cells—which are responsible for blood clotting, transportation of oxygen, and immune defense against microorganisms that cause disease—are made in the marrow of our bones. Bone marrow is a spongy substance and houses the progenitor cells that give rise to our many different kinds of blood cells. In rare cases, these progenitor cells, do not develop properly and immature blood cells, also known as “blasts,” build up in the bone marrow and can be found in the blood. Their build-up reduces the number of healthy blood cells that are produced. These cases are known collectively as myelodysplastic syndromes (MDS) and are characterized by some combination of low blood cell counts (low red blood cells, low platelets, and/or low white blood cells). According to the World Health Organization, there are seven subtypes of MDS:

Refractory anemia (RA)

Refractory anemia with ringed sideroblasts (RARS)

Refractory cytopenia with multilineage dysplasia (RCMD)

Refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS)

Refractory anemia with excess blasts (RAEB)

Myelodysplastic syndrome, unclassified (MDS-U)

MDS associated with isolated del(5q)

Our blood cells—which are responsible for blood clotting, transportation of oxygen, and immune defense against microorganisms that cause disease—are made in the marrow of our bones. Bone marrow is a spongy substance and houses the progenitor cells that give rise to our many different kinds of blood cells. In rare cases, these progenitor cells, do not develop properly and immature blood cells, also known as “blasts,” build up in the bone marrow and can be found in the blood. Their build-up reduces the number of healthy blood cells that are produced. These cases are known collectively as myelodysplastic syndromes (MDS) and are characterized by some combination of low blood cell counts (low red blood cells, low platelets, and/or low white blood cells). According to the World Health Organization, there are seven subtypes of MDS:

Refractory anemia (RA)

Refractory anemia with ringed sideroblasts (RARS)

Refractory cytopenia with multilineage dysplasia (RCMD)

Refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS)

Refractory anemia with excess blasts (RAEB)

Myelodysplastic syndrome, unclassified (MDS-U)

MDS associated with isolated del(5q)

Our specialists collect information regarding medical history, surgical history, social history, and family history; conduct laboratory testing, and review radiological studies to approach patient care in the most comprehensive and personalized manner.

The blood test normally used to assess for blood disorders is known as the “Complete Blood Count.” This test will allow your doctor to determine if you have an abnormal amount of any one or any combination of blood cell types. To investigate a suspicious finding further, your doctor may choose to order a flow cytometry or bone marrow biopsy. A flow cytometry is a cell counting technique used to gather more information about cells in the blood. A bone marrow biopsy is a tissue sampling technique used to determine the composition of the bone marrow and whether or not it is involved by an abnormality, such as myelodysplastic syndrome.

Myelodysplastic syndromes generally occur either because there has been damage to the bone marrow or because bone marrow cells possess a genetic abnormality, such as a deletion of genetic material from chromosome 5 in the case of MDS associated with isolated del(5q). Although an increased likelihood of developing an MDS is associated with the following factors, MDS often develops without a readily identifiable cause:

• Aging
• Personal history of chemotherapy
• Exposure to tobacco smoke
• Exposure to benzene
• Exposure to heavy metals
• Exposure to Agent Orange
• Exposure to pesticides
• Exposure to radiation

Treatment of myelodysplastic syndromes, depending on the type, may include observation, blood transfusions to improve blood cell counts, chemotherapy, and/or other therapeutic approaches. Treatments may be used individually or in combination based on your doctor’s recommendations. It’s important to discuss all of your treatment options with your doctor to help make the decision that best fits your needs. Some important factors to consider when deciding on a treatment plan include

• Your age, health, and lifestyle.
• Your specific type of myelodysplastic syndrome.
• Any other serious health conditions you have.
• Your feelings about the need to treat the myelodysplastic syndrome right away.
• Your doctor’s opinion about if you need to treat the myelodysplastic syndrome right away.
• The likelihood that treatment will help fight your myelodysplastic syndrome.
• Possible side effects of each treatment method.

You may feel the need to make a quick decision, but it is very important to ask questions if there is anything you’re not sure about. It is very important for you and your doctor to communicate and work together to weigh the benefits of each treatment option against the possible side effects and to ultimately determine what treatment option is best for you.