About Myelodysplastic Syndrome

Myelodysplastic syndrome (or MDS) is not a single disease but a group of disorders primarily affecting the bone marrow, with the abnormality most prominently reflected in decreased red cell, white cell and platelet counts. Myelodysplastic syndrome is also known as pre-leukemia. The disease usually strikes older adults; about half the patients with myelodysplastic syndrome are more than 65 years of age.

There are two types of myelodysplastic syndrome: primary and secondary MDS. Whereas primary myelodysplastic syndrome has no known cause, secondary MDS follows known or documented exposure to toxic or chemical agents such as chemotherapy or radiation.

Although patients with the disease may have low blood counts, the real problem lies in the bone marrow, which is responsible for producing the stem cells that later give birth to white blood cells, red blood cells and platelets. The cause of MDS or what goes wrong with these stems cells remains unknown, but possibilities include viral infection, genetic damage caused by chemical exposure or toxic damage.

Treatment for Myelodysplastic Syndrome

Patients are carefully screened before treatment recommendations are made so that treatment can be tailored to meet the health needs of each patient. Blood and platelet transfusions continue to be the standard treatment approach with MDS. Transfusions are given to patients as needed to combat infectious episodes.

Although not every patient is eligible for this form of treatment, bone marrow transplantation is the only known cure for the disease. Certain patients with myelodysplastic syndrome may be eligible for allogeneic stem cell transplantation. If a patient has no sibling donor it may be possible to find an unrelated donor on the National Marrow Donor Program Registry.

For more information about the Bone Marrow Transplant Center at Rush University Medical Center in Chicago, Illinois, visit our Bone Marrow Transplant Center home page.

Growth factors, such as Neupogen and Epogen, have been used extensively in the past to increase the proliferation of white blood cells and red blood cells, respectively. Although their long-term effectiveness has been questioned, it is clear that these agents have a place in the treatment of myelodysplasia and that their judicious use can be life-saving.

Anti-cytokine therapy, a novel strategy pioneered at Rush, has been found to have a relationship to cell death in bone marrow. Several agents, including Pentoxifylline, Cipro and Decadron (PCD), amifostine and thalidomide, have been evaluated in various combinations, and the results have been encouraging. Newer strategies for treatment based on improved biological understanding are evolving rapidly. These include more effective compounds derived from drugs that have previously been found to be useful.