Myelodysplastic syndrome (also called myelodysplasia or MDS) affects blood stem cells. People with MDS don’t have enough healthy blood cells. MDS can cause anemia, frequent infections and bleeding that won’t stop. Some people with MDS develop acute myeloid leukemia. MDS treatment focuses on keeping it from getting worse.
Myelodysplastic syndrome (also called myelodysplasia or more recently, myelodysplastic neoplasm) refers to a group of cancers that keep your blood (hematopoietic) stem cells from maturing into healthy blood cells. Without enough healthy blood cells, you may develop serious conditions like anemia, frequent infections and bleeding that won’t stop. Some people with MDS may develop acute myeloid leukemia (AML).
MDS is rare. It affects about 4 in 100,000 people in the U.S. each year. If you have MDS, your healthcare providers will focus treatment on slowing its progress, easing your symptoms and treating the conditions it causes.
There are six MDS types. Healthcare providers categorize the condition after reviewing results of tests that show:
MDS types | Characteristics |
---|---|
MDS with multilineage dysplasia (MDS-MLD) | Some of the blood cells or platelets in your bone marrow are oddly shaped or look different from healthy cells. Your provider may refer to this as dysplasia. You have the normal number of blasts, but you have low levels of at least one blood cell type. If you have this subtype, you may eventually develop AML. |
MDS with single lineage dysplasia (MDS-SLD) | At least one of the immature blood cell or platelet types in your bone marrow looks different from healthy cells or platelets. There are low levels of one or two of your blood cell types and you have the normal number of blasts in your bone marrow and few or no blasts in your blood. This type of MDS rarely becomes AML. |
MDS with ring sideroblasts (MDS-RS) | In this type of MDS, about 15% of immature red blood cells are ring sideroblasts, and dysplasia affects one or two cell types in your bone marrow. Rarely, it turns into AML. |
MDS with excess blasts (MDS-EB) | You may have anemia. Tests show low levels of two of your three blood cell types and that you have a significant number of blasts. About 40% of people diagnosed with MDS-EB eventually develop AML. |
Myelodysplastic syndrome associated with an isolated del (5q) chromosome | Special tests to analyze cells show a certain chromosome part is missing. |
Myelodysplastic syndrome, unclassifiable (MDS-U) | Tests show you have fewer blood cells than usual, or abnormal chromosome but no other MDS signs. |
MDS types | |
MDS with multilineage dysplasia (MDS-MLD) | |
Characteristics | |
Some of the blood cells or platelets in your bone marrow are oddly shaped or look different from healthy cells. Your provider may refer to this as dysplasia. You have the normal number of blasts, but you have low levels of at least one blood cell type. If you have this subtype, you may eventually develop AML. | |
MDS with single lineage dysplasia (MDS-SLD) | |
Characteristics | |
At least one of the immature blood cell or platelet types in your bone marrow looks different from healthy cells or platelets. There are low levels of one or two of your blood cell types and you have the normal number of blasts in your bone marrow and few or no blasts in your blood. This type of MDS rarely becomes AML. | |
MDS with ring sideroblasts (MDS-RS) | |
Characteristics | |
In this type of MDS, about 15% of immature red blood cells are ring sideroblasts, and dysplasia affects one or two cell types in your bone marrow. Rarely, it turns into AML. | |
MDS with excess blasts (MDS-EB) | |
Characteristics | |
You may have anemia. Tests show low levels of two of your three blood cell types and that you have a significant number of blasts. About 40% of people diagnosed with MDS-EB eventually develop AML. | |
Myelodysplastic syndrome associated with an isolated del (5q) chromosome | |
Characteristics | |
Special tests to analyze cells show a certain chromosome part is missing. | |
Myelodysplastic syndrome, unclassifiable (MDS-U) | |
Characteristics | |
Tests show you have fewer blood cells than usual, or abnormal chromosome but no other MDS signs. |
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You can have MDS without having any symptoms. Sometimes, people learn they have a type of this syndrome after having routine blood tests. Low levels of red blood cells (anemia) are the most common symptom. But anemia symptoms and other MDS symptoms can resemble other less serious conditions.
Check with your healthcare provider if you notice the following changes, particularly changes that don’t go away within a few weeks:
People seem to develop MDS in one of two ways: They participate in activities that increase their risk of developing the syndrome or they inherit certain conditions.
Between 4% and 15% of people with this condition have inherited conditions that increase the chance they’ll have the disease. Those conditions include:
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Providers take several steps to diagnose myelodysplastic syndrome:
Providers evaluate or stage the condition based on the risk that the syndrome will become acute myeloid leukemia (AML). They use a risk rating system called the International Prognostic Scoring System. Here are factors that providers consider:
Healthcare providers consider several factors when developing MDS treatment plans:
Treatment for myelodysplastic syndrome may include supportive care and treatment to get rid of unhealthy blood cells. Supportive care may include:
Treatments to get rid of unhealthy blood cells may include:
These treatments have different side effects and complications. As you’re thinking about treatment options, ask your healthcare provider about each option’s side effects and complications.
People with myelodysplasia may benefit from palliative care. This care helps people manage MDS symptoms and treatment side effects. Just as important, it may help people manage the emotional impact of living with a chronic disease.
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No, but understanding MDS risk factors may help healthcare providers diagnose and treat MDS early on. Myelodysplasia syndrome is linked to chemotherapy and radiation therapy, as well as exposure to certain chemicals and heavy metals. Talk to your healthcare provider about your medical history and any activities that placed you in close and prolonged contact with chemicals and heavy metals. They’ll help you assess your personal risk.
The only cure for MDS is a successful stem cell transplant. Unfortunately, not everyone can have this treatment. Ask your healthcare provider if a transplant is a choice you should consider.
Myelodysplastic syndrome is a serious health issue that can cause life-threatening conditions. It’s also a complicated health issue that affects people in different ways. Your healthcare provider is your best source of information about your individual prognosis or expected outcome.
MDS affects people in different ways. Some people have MDS but no symptoms. If that’s your situation, your provider may recommend blood tests every three months to monitor any changes in your blood stem cells. If you have MDS and are receiving supportive treatment such as blood transfusions, you may need more treatment to reduce how many blood transfusions you need. Here are some steps you can take that may support your treatment:
Myelodysplastic syndrome can cause conditions like anemia, bleeding issues and infections. You should go to the emergency room any time you:
Myelodysplastic syndrome is rare, so you’ll likely have many questions about what you can expect. Here are some questions you may want to ask your healthcare provider:
A note from Cleveland Clinic
If you have myelodysplastic syndrome (MDS), you have a form of cancer that’s a chronic illness. No illness is easy, but having a chronic illness means also managing the emotional impact of an illness that won’t go away. But living with MDS doesn’t mean living without hope. Some treatments may slow down MDS. You may be a candidate for a clinical trial evaluating new ways to treat myelodysplastic syndrome. And there are things you can do to help yourself. Ask your healthcare provider about lifestyle changes, like eating well and getting exercise, which can help you be as healthy as possible.
Last reviewed on 07/10/2023.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy