Myelodysplastic syndromes (MDS) are a group of blood cancers that affect the bone marrow and can result in a low levels of blood cells. When MDS affects red blood cells, it can lead to anemia in some people.
A low red blood cell count (hemoglobin) is a key feature of anemia. With MDS, anemia occurs because the bone marrow does not work correctly. This can be due to several reasons, including the accumulation of irregular cells in the bone marrow and the bone marrow not producing blood cells properly.
MDS-associated anemia can lead to symptoms such as fatigue, weakness, and pale skin. Treatment usually involves addressing the underlying cause of MDS. Many supportive measures are available to help improve a person’s quality of life.
Read on to learn more about anemia with MDS, including symptoms, causes, and treatment. This article also discusses the outlook for MDS.
Anemia is
What causes MDS?
While the exact cause of MDS is unclear,
MDS can cause low levels of different types of blood cells in the bone marrow.
Also, the following may increase a person’s risk of developing MDS:
- having radiation therapy
- undergoing chemotherapy
- certain chemicals
- smoking
Anemia associated with MDS
In MDS, anemia develops because the bone marrow is
Irregular or immature cells may accumulate in the bone marrow, crowding “normal” red blood cells. Or, the MDS may mean that the bone marrow cannot make red blood cells properly.
Anemia in MDS can lead to the following
These are typical symptoms of anemia, even if MDS is not the underlying cause.
However, a person’s symptoms can depend on other factors, including the underlying cause of anemia. If MDS is the underlying cause, symptoms may differ according to how far advanced the MDS is.
To diagnose MDS-associated anemia, doctors will do the following:
- check a person’s medical and family history
- a physical exam
- order tests
Testing
The tests will
- red blood cells
- white blood cells
- hemoglobin, which is the oxygen-carrying protein in red blood cells
Lab technicians can also assess the size, shape, and number of blood cells using a blood smear.
Doctors might also decide to check for atypical levels of other substances, such as:
- folate
- vitamin B12
- erythropoietin, which is a hormone the kidneys make to help produce red blood cells
- iron stores
Doctors may also recommend bone marrow testing. These tests can identify any irregularities relating to the number, type, size, and shape of blood cells and any changes to the cell’s genes.
Treatment options for anemia and MDS are detailed below:
Treating anemia
Doctors treat anemia by finding and treating the underlying cause. This could involve avoiding exposure to a particular chemical or MDS medication.
Treatment aims to improve red blood cell counts. This can bring symptom relief and improve a person’s quality of life.
A person may receive one or more of the following therapies:
- dietary supplements, depending on the exact cause, iron or vitamin B12 supplements may help
- medications
- blood transfusion
- blood and bone marrow transplants
Treating underlying MDS
It usually involves supportive care, which
- relieve symptoms
- improve quality of life
- prevent bleeding and infections
Supportive care is beneficial as most people with MDS are older adults who may have additional health problems.
Other possible treatments for MDS include occasional or more regular blood transfusions, which temporarily relieve anemia, fatigue, and bleeding. Blood transfusions work by increasing the number of red blood cells, platelets, or both in a person’s blood.
MDS medications include ones that:
- stimulate bone marrow
- treat or prevent infections
- prevent the growth of irregular bone marrow stem cells and increase the number of healthy blood cells — for example, the hypomethylating agents azacitidine or decitabine
- slow the growth of irregular blood cells and reduce the need for blood transfusions — for example, the immune modulator lenalidomide
Stem cell transplants
That said, stem cell transplants can provide a possible cure for some people. This involves replacing a person’s damaged stem cells with healthy stem cells from a closely matched donor. A person with MDS may receive chemotherapy alongside a stem cell transplant or by itself.
Those waiting for a stem cell transplant or those ineligible for one may benefit from immunosuppressive therapy. This works on the immune system, slowing or stopping bone marrow damage.
A
Blood transfusions can help treat the anemia, but there can be downsides, such as iron buildup in the body. A person may then need iron chelation therapy. They can also experience higher healthcare costs and lower quality of life.
Doctors
- a person’s levels of red blood cells, white blood cells, and platelets
- the percentage of blasts (immature cells) in their bone marrow
- whether they have chromosome changes and which types
Doctors can then assign a person to a risk group to estimate how likely they are to develop acute myeloid leukemia — a rare cancer of the bone marrow and blood — and their overall chances of survival.
The table below outlines overall survival times for MDS, as reported by the
| IPSS-R risk group | Median survival time |
| very low | 8.8 years |
| low | 5.3 years |
| intermediate | 3 years |
| high | 1.6 years |
| very high | 0.8 years |
MDS is a group of rare blood cancers that result in the bone marrow struggling to produce healthy blood cells, including red blood cells. In some people, MDS can lead to anemia.
Having anemia with MDS can lead to symptoms of fatigue, unusually pale skin, shortness of breath during activity, and dizziness, among others. Doctors may diagnose the condition based on results from blood tests, which show low levels of healthy red cells and other blood components.
Treatment focuses on treating symptoms and can include a combination of blood transfusions, stem cell transplants, immunosuppressive therapy, and medications.
A person’s outlook depends on many factors, including how they respond to treatment and how advanced the MDS is.