Bone Marrow Failure in the Elderly: Myelodysplastic Syndromes (MDS)

What are Myelodysplastic Syndromes (MDS)?

Myelodysplastic Syndromes (MDS) are a group of bone marrow failures in the elderly that occur when bone marrow is not producing enough red blood cells in the elderly patient. MDS in elderly patients are often unrecognized and under-diagnosed.

Although the condition can affect young adults and even children, 75% of cases occur in people who are over the age of 60.

The exact causes of MDS are unknown but there are possible triggers such as chemotherapy and radiation for cancer, smoking and toxic chemicals.

Long-term exposure to certain industrial chemicals such as benzene can be attributed to the development of the condition.

Benzene is found in paint, gasoline, glue, varnish removers, dyes, resins, and a host of other products. Although it is now highly regulated, those regulations have not always been in place.

This has resulted in many elderly people being diagnosed with the disease now because products and restrictions were not common when they were in the work force.

What is MDS Disease Progression in the Elderly?

The progression of MDS can take several years or in some cases the progression occurs quickly. As Myelodysplastic Syndromes progress, bone marrow failure occurs, which can lead to hemorrhage or other complications such as anemia. The disease can lead to Acute Myeloid Leukemia, which is life threatening. The risks of MDS in elderly people increase with age.

The following conditions could indicate the beginning stages of MDS:

· Anemia- too few red blood cells. This can cause dizziness, fatigue, pale skin, and shortness of breath.

· Severe Infections-If you are not producing enough white blood cells, you may have recurrent infections that do not respond well to treatment.

· Blood Platelet Insufficiency- Too few blood platelets will result in frequent nosebleeds, bruising, and bleeding gums.

· Unexplained Weight Loss

· Bone Pain

· Loss of Appetite

· Fevers with no apparent cause

These signs could all be indicators of conditions other than MDS, but if you are experiencing any of these symptoms and they are unexplained or getting worse with time, you should see your doctor for an evaluation to rule out MDS. Early detection and treatment may delay the progression of the disease.

Treatment for MDS in the Elderly:

MDS treatment in elderly people depends on factors such as the type of MDS you have, or whether you have other medical conditions. The goal of treatment is to relieve symptoms and improve the quality of life. The proper treatment may lead to remission and bring blood counts back to as near normal levels as possible.

A team of doctors can work together to develop an overall treatment plan. Your care may include several professionals (nurses, pharmacists, dieticians) that offer input for the best way to treat your symptoms. This group is commonly referred to as a multi-disciplinary team. Click here for additional treatment information.

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What is the MDS Prognosis in Elderly Patients?

Myelodysplastic Syndromes are sometimes referred to as pre-leukemia. Life expectancy can range from months to years, depending on your age, your overall health, risk factors you may have, and how well you respond to treatment. Your doctor can use a score system to determine your MDS prognosis and plan of care. Elderly patients with MDS don’t always develop Acute Myeloid Leukemia. That is why it is so important to receive a diagnosis and treatment plan as soon as symptoms appear.

Be proactive, follow the advice of your medical professionals, and try to eliminate as many risks as possible for the best outcome and best quality of life.