Myelodysplastic syndromes (MDS)

Yes. Myelodysplastic syndromes (MDS), also called myelodysplastic neoplasms, are a group of cancers of the blood-forming cells in the bone marrow. Immature blood cells do not grow into healthy working cells, which leaves less room for healthy red cells, white cells and platelets to form. This leads to low blood counts. Subtypes are named for features of the marrow cells and their genetic changes.

MDS often causes no symptoms early on, and it may first be found on a routine blood test. When symptoms do appear, they can include feeling weak or tired, shortness of breath, skin that is paler than usual, and bruising or bleeding easily. These signs can also be caused by other conditions, so having them does not mean someone has MDS.

Some people can be cured. The National Cancer Institute says a donor stem cell transplant, called an allogeneic transplant, is the only treatment that can potentially cure MDS. It is considered for selected patients, not everyone. Medicines and supportive care are important options too. Care teams weigh factors such as the share of blasts, genetic changes, symptoms, age and general health when planning treatment.

No. A transplant is generally not recommended for people with very low-risk or low-risk MDS. This often includes MDS with low blasts and a 5q deletion or an SF3B1 mutation, which usually have a better outlook than MDS with more blasts. Many people in these groups are treated with supportive care, such as transfusions or medicines that help the body make red blood cells. For eligible people with higher-risk MDS, including many with increased blasts, a donor transplant is often considered.

It can, but it does not always happen. The National Cancer Institute says some types of MDS may progress to acute myeloid leukemia (AML), and the chance differs between subtypes. The share of immature cells, called blasts, in the marrow is one factor doctors use to judge the outlook. Some medicines used for MDS, such as azacitidine and decitabine, may slow progression to AML.

It varies widely. Doctors estimate outlook with risk scores that combine blood counts, the share of immature cells (blasts) and chromosome changes. Newer scores add gene changes too. The outlook section on this page gives survival for each risk group of one widely used score, the IPSS-R. Those figures come from people who had not had treatments that change the course of MDS, such as a transplant. Today's treatments can change the outlook for some people, and no number can predict how one person will do.