Anemia
Myelodysplastic Syndrome
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Myelodysplastic Syndrome
, Myelodysplastic Anemia, MDS
Pathophysiology
Marrow disorder leading to
Macrocytic Anemia
Pre-
Leukemia
syndrome (precedes advanced MDS by 10 years)
Epidemiology
Median age of onset: 70 years old
Incidence
: 162 per 100,000 patients (2003, U.S. Medicare population)
Risk Factors
Prior
Chemotherapy
(5-10% of cases)
Prior radiation exposure (<5% of cases)
Labs
Complete Blood Count
Macrocytic Anemia
Peripheral Smear
with oval
Macrocyte
s
Comorbid
Neutropenia
or
Thrombocytopenia
in <50% of cases
Anemia Labs
Normal B12
Vitamin
Normal
Folate
Bone Marrow Biopsy
Hypercellular aspirate with dysplastic cells
Increased blasts suggests higher risk of more rapid progression to
Leukemia
Management
Erythopoetin Stimulating Agents
Chemotherapy
Lenalidomide
Azacitidine
Course
Progresses to
Acute Myelogenous Leukemia
in 25% of cases
Complications of MDS (
Anemia
, bleeding or infection) results ultimately in death in 50% of cases
References
Mesa (2011) Internal Medicine, Mayo Conference, Kauai
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