What is MDS?

Tuesday, June 19, 2012 - 11:57am
Staff Physician, Leukemia Service, Department of Medicine

After breast cancer survivor, and TV personality Robin Roberts revealed a recent diagnosis of myelodysplastic syndrome (MDS) on ABC’s “Good Morning America,” I was asked to demystify the disease and help educate the public. MDS is a cancer of the bone marrow that causes stem cell abnormalities and a disruption of blood and platelet production. What I often see in patients with MDS is too many young cells that don’t mature or function properly. Because of this, patients are often left anemic and fatigued. They bruise or bleed easily due to low platelets and sustain frequent fevers or infections as a result of decreased infection-fighting cells.

Currently, the standard of care for this disease is treatment with a drug called azacitidine (Vidaza), which has changed the face of MDS. It has not only improved quality of life, but also increased survival. Another drug in the same family is decitabine (Dacogen). These medications are thought to nudge the sick stem cells into doing their job more effectively with very little side effects. Most of the patients who develop MDS are over 65, however, the young are not exempt. For patients with an otherwise clean bill of health, bone marrow transplantation is the only curative option.

MDS is often the result of “friendly fire” accidentally sustained while a patient is being treated for another type of cancer; often breast, prostate or lung. Luckily, less than 1 percent of patients who get exposed to chemotherapy for breast cancer will develop a bone marrow problem. Although this is a known and serious risk, it is not a common one. In addition to chemo exposure, ionizing radiation, cigarette smoking and benzene (from exhaust and fossil fuels) can pose a threat. Despite these risk factors, MDS is a relatively rare disease.