Myelodysplastic Syndrome

What is Myelodysplastic Syndrome ?

Myelodysplastic syndrome prognosis is what people want to know when a family member or loved one is diagnosed with the condition. Myelodysplastic syndrome or MDS refers to a group of disorders affecting the blood and bone marrow. It comes in different forms, with some easily managed while others are life-threatening. Acute Myelogenous Leukemia, a severe form of leukemia which is very difficult to treat, may develop from certain forms of MDS. People with MDS can survive from 6 months up to 6 years.

Learning about the Myelodysplastic Syndrome prognosis will help patients and their families take the necessary steps to manage the condition, with hopes of achieving positive results. The condition may be difficult to diagnose but early detection greatly helps in choosing the best treatment option that will give a positive prognosis.

Myelodysplastic Syndrome causes

Under normal conditions, the bone marrow is responsible for producing immature cells which may either become lymphoid or myeloid stem cells. Lymphoid stem cells will eventually become white blood cells when they mature, while myeloid stem cells can either turn into red blood cells, white blood cells or platelets upon maturity. However, MDS happens when these young cells fail to mature and become healthy blood cells. These immature cells function abnormally and may either die upon entering the bloodstream or within the bone marrow itself. With abnormal immature cells flooding the bone marrow, healthy blood cells will find no room to thrive in. A body that has fewer healthy blood cells is more susceptible to diseases and infections as well as bleeding.

Myelodysplastic Syndrome symptoms

Knowing the symptoms of MDS is essential for its early detection and higher chances of getting a positive Myelodysplastic Syndrome prognosis. The manifestations of the disease quite differ between patients depending on the blood cell type affected and the severity of the illness. More often than not, the symptoms are hard to detect when the disease is still in its initial stages and become more obvious as it progresses. Some of the symptoms to watch out for include:

• Fatigue
• Bruising and bleeding easily
• Breathing difficulties
• Frequent bouts of infection
• Fever
• Small red spots underneath the skin

It is important to be observant with the symptoms of MDS as it may become life-threatening in just a few months.

Who are at risk of having MDS?

Statistics show that around 80% of MDS patients are male who are 60 years old and above. Exposure to some chemicals and heavy metals, including radiation and chemotherapy, increases the risk of developing Secondary Myelodysplastic Syndrome.  Meanwhile, those who do not have the risk factors may develop De Novo Myelodysplastic Syndrome.

 Myelodysplastic Syndrome Diagnosis

The doctor will conduct several tests to come up with the Myelodysplastic Syndrome prognosis. The test results will help him or her in classifying the natural course and stage of the disease, as well as plan the most appropriate treatment method. These tests include:

• CBC with differential
• Physical Examination
• Peripheral blood smear
• Bone marrow biopsy
• Cytogenetic Analysis
• Immunophenotyping

Types of Myelodysplastic Syndrome 

Doctors are using MDS classification systems to stage and figure out a patient’s condition, the chances of the disease developing into AML, and the overall prognosis. These classification systems consider the extent of low blood cell count and chromosomal changes as well as the amount of immature cells (blast) in the bone marrow.

• WPSS (WHO Prognostic Scoring System)

This is a classification system by the World Health Organization to categorize MDS subtypes into: RA, RARS, RCMD, RCMD-RS, RAEB, MDS-U, 5q, JMML and CMML.

• IPSS (International Prognostic Scoring System)

MDS is classified into four subtypes in IPSS classification system such as low risk, intermediate risk-1, intermediate risk-2 and high risk.

Myelodysplastic Syndrome prognosis

The amount of immature blood cells in a patient’s bone marrow and certain chromosomal changes can influence the prognosis of MDS. MDS prognosis also seems to be affected if it occurred following radiation or chemotherapy due to another disease. The outcome of the illness is also affected when multiple blood cell types are affected. People who have high amounts of immature cells in their bone marrow as well as those who have low levels of blood cells and numerous chromosomal abnormalities have poor prognosis.

Myelodysplastic Syndrome treatment

There are several treatment options from which MDS patients can choose, but these do not completely cure the disease. MDS treatment is meant to manage the symptoms and improve the quality of life of MDS patients. Some may not need treatment for years but others require aggressive therapy. Doctors may employ any or a combination of the following treatment methods.

• Blood transfusion to increase red blood cell count.
• Medications to fight infections and growth factors to promote blood cell production in the bone marrow.
• Chemotherapy to reduce the amount of abnormal cells.
• Stem cell transplant to replace the defective bone marrow.

Myelodysplastic Syndrome prognosis differs between patients; still, learning the symptoms and risk factors helps in the early detection of the condition which will improve the patient’s prognosis.

Myelodysplastic Syndrome  life expectancy

Some non-transplant patients can live for an average of three to five years, while some live for more than ten years. Long-term remission is seen in cases when bone marrow transplant is done successfully. The best prognosis for Myelodysplastic syndrome is in cases of  refractory anemia with ringed sideroblasts.

The worst case is in RAEB-T, where the mean life expectancy for Myelodysplastic syndrome is less than 1 year. The causes of deaths can be leukemia, low blood count or unassociated disease.