MDS is a group of stem-cell disorders characterised by ineffective haematopoiesis resulting in cytopenia, and potential progression to AML in a third of patients.1 They occur due to clonal mutations triggering the suppression of normal stem cell development.2 80% of MDS cases are idiopathic, but autoimmune disorders and exposure to radiotherapy, chemotherapeutic agents, toxic chemicals and viral infections can increase the risk of these mutations.1,2
The incidence of MDS is approximately 4.9 per 100,000,2 with risk increasing with age. Less than 10% of MDS patients are <50 years old;1 the median age at presentation is approximately 70–75 years,3 with a prevalence in males and caucasians.4
Bleeding and infections represent the most common cause of mortality,2 and the 3-year survival rate is approximately 60%.4
Treatment in high risk patients aims to avoid progression to AML using hypomethylating agents as first-line therapy. In low-risk patients, the focus is on the treatment of cytopenias such as anaemia, where high-dose erythropoiesis-stimulating agents are the first-line therapy.1 More than 80% of people with MDS experience anaemia and often require repeated RBC transfusions to manage their symptoms6
MDS and the risk of iron overload
Repeated transfusions can cause complications, and iron overload is an inevitable consequence for many patients with MDS.6
Abbreviations: AML, acute myeloid leukaemia; MDS, myelodysplastic syndromes; RBC, red blood cell.
- Adès L, et al. Myelodysplastic syndromes. Lancet 2014;383:2239–2252.
- Mohammad AA. Myelodysplastic syndrome from theoretical review to clinical application view. Oncol Rev 2018;12(397):134–142.
- Weinberg OK and Hasserjian RP. The current approach to the diagnosis of myelodysplastic syndromes. Sem Haem 2019;59:15–21.
- Goldberg S, et al. Incidence and clinical complications of myelodysplastic syndromes among United States Medicare beneficiaries. J Clin Oncol 2010;28(17):2847–2852.
- Martinez SFM, et al. Myelodysplastic syndrome clinically presenting with the “Classic TTP Pentad”. Case Reports in Hematology 2017:4619406.
- Balducci L. Transfusion independence in patients with myelodysplastic syndromes. Cancer 2005;106:2087–2094.