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Myelodysplastic Syndrome - Introduction

Myelodysplastic syndrome or MDS is not a common diagnosis. In most patient, the diagnosis came out of the blue, as part of investigations for abnormal blood test. The abnormal blood test were often anaemia, without much symptoms in the patient. There was typically no period of illness. There was no organ swelling to alert the patient of the diagnosis. Quite often the diagnosis came later in its course, in the form of acute leukaemia.

As the name suggest, MDS is a condition where by the stem cell and its early progenitor which were supposed to produce daughter cells in the form of mature red and white blood cells and platelet, became defective or dysplastic. These abnormal or dysplatic cells, do not produce viable cells to go in circulation, and often our body’s own mechanism will prevent its release. They are stuck in the patient’s marrow. Consequently, the patient will have low peripheral blood count but when a bone marrow aspirate tests were performed, there will often be very cellular. This is the hallmark of MDS. This abnormal cell will accumulate over time and the mutation can result in transformation into leukaemia, the most feared outcome of this condition.

The job of the Haematologist is first to diagnose the condition. Once this is established, tests will be done to see in which prognostic group patient belong. From here, we can predict how likely the disease will transform into leukaemia, and when and what form of treatment suits the patient best. Therefore, treatment for this disease is very individualised and best handled by at a specialised center. 

The disease usually presents in the elderly population with a slight male preponderance just as with other cancers, often as incidental finding. There is a subgroup of patient who develop MDS due to previous chemotherapy treatment for haematological or other cancer. This subgroup has a worst prognosis and often transform into leukaemia very quickly. Apart from that, MDS is not an inherited condition, nor due to previous infection. To discuss this condition, I will divide my entries into; diagnosis and classification, prognostic markers established, and available treatment options.

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