Myelodysplastic syndromes (MDS) are cancers that affect blood cells in the bone marrow. In MDS, blood cells don’t develop normally. This means there are fewer healthy blood cells in your body.

Keep reading to learn more about MDS, symptoms to look out for, and how it’s diagnosed and treated.

MD是指影响您的髓样干细胞的癌症的集合骨髓。Normally, these stem cells go on to make:

  • 红细胞（RBC）that carry oxygen throughout your body
  • 白细胞（WBC）对感染的反应
  • 血小板that help blood to clot

In MDS, some types of stem cells don’t develop properly and appear abnormal, or dysplastic. MDS also leads to higher numbers of immature blood cells in your body. These immature cells are called blasts.

爆炸细胞要么在生产后迅速死亡，要么发挥不佳。他们还挤出了您所拥有的健康血细胞。这种拥挤最常影响RBC的水平，导致贫血。

Some types of MDS can go on to transform intoacute myeloid leukemia (AML)。AML is a type of leukemia that can grow and progress rapidly if it isn’t treated.

MDS的确切原因是未知的。但是，遗传变化是在您的一生中继承或获得的，似乎起着重要作用。MDS的已知风险因素是：

  • 年龄较大
  • 出生时分配的男性
  • 以前的治疗方法chemotherapy
  • a family history of MDS
  • certain genetic conditions, such as Fanconi anemia
  • high exposure to radiation or certain industrial chemicals

有些患有MD的人可能没有任何明显的症状。在这种情况下，可以在常规的血液测试或针对其他健康状况测试期间检测到MD。

Many of the types of MDS have overlapping symptoms. Symptoms happen due to a decrease in healthy blood cells in the body and can include:

See a doctor if you have any of the symptoms above, particularly if they cannot be explained by a known health condition. The doctor can help determine if your symptoms are caused by MDS or something else.

这 World Health Organization (WHO) currently recognizes 6 types of MDS divided up based on characteristics like:

  • whether cells look abnormal under a microscope (dysplasia)
  • 低血细胞的存在计数（RBCS，，，，WBCS,血小板）
  • 血液，骨髓或两者的爆炸次数
  • 是否存在其他功能，例如戒指的Sideroblasts或染色体更改

这different types of MDS are:

  • MDS with multilineage dysplasia (MDS-MLD).MDS-MLD is the most common type of MDS. There’s a normal level of blasts. But dysplasia affects two or three blood cell types, and numbers of at least one blood cell type are lower than normal.
  • 具有单谱系异常增生（MDS-SLD）的MDS。这re’s still a normal number of blasts. Dysplasia impacts only one blood cell type, and numbers of at least one or two blood cell types are lower than normal.
  • 带有环粒细胞（MDS-RS）的MD。Early RBCs have rings of iron calledring sideroblastsinside them. There are two subtypes, based on the amount of dysplasia seen.
  • MDS with excess blasts (MDS-EB).血液，骨髓或两者兼有大量爆炸。通常还可以看到一种或多种血细胞类型的低水平。根据发现多少个爆炸，有两个亚型。这种类型最有可能转变为AML。
  • MDS with isolated del(5q).Cells in the bone marrow have a deletion in their 5th chromosome. Low blood cell levels, often RBCs, and dysplasia are also seen.
  • MDS，无分类（MDS-U）。这findings of blood and bone marrow tests don’t align with any of the other five types above.

这WHO also has a separate classification called myelodysplastic syndromes/myeloproliferative neoplasms (MDS/MPN). These are cancers that have features of both MDS and myeloproliferative neoplasms (MPN). Examples include:

MD很难诊断，因为它们很难与影响血液和骨髓的其他疾病区分开。

After getting your medical history and doing a physical examination, a doctor will use the following tests to help diagnose MDS:

  • complete blood count (CBC)withdifferential测量不同血细胞类型的量
  • peripheral blood smearto assess the appearance of blood cells under a microscope
  • 铁，维生素B12或叶酸水平的测试to rule out other causes of anemia
  • 骨髓抽吸andbiopsy提供可以检查的样品以检测与MDS相关的异常
  • 染色体测试称为细胞遗传学来寻找MDS中出现的染色体变化
  • genetic testingto check for certain genetic changes that happen in MDS

After diagnosis, the doctor will also use a scoring system to help predict your likely outcome, or预后分数。影响结果的一些因素包括：

  • 您拥有的MDS类型
  • 你的血细胞计数
  • 存在的爆炸百分比
  • 是否发现某些遗传或染色体变化
  • 转换向AML的风险
  • how severe your symptoms are
  • your age and overall health

使用了几个评分系统。您将在某种水平的低，中级或高风险中分类。

这doctor will make treatment recommendations based on your risk level.Treatment optionscan include:

  • 观看并等待。This approach is used if you don’t have symptoms and are classified as low or intermediate risk. A doctor will monitor you and provide supportive therapy. They’ll recommend treatment if you develop symptoms or if tests show your condition is progressing.
  • Stem cell transplant (SCT).一个sct从一个匹配donor, often a sibling, can potentially cure MDS. Ideal candidates for this procedure are young and in overall good health.
  • 基于药物的疗法。多种药物疗法可以用于MDS, particularly if an SCT isn’t an option. These may include:
    • immunomodulators like lenalidomide (Revlimid），专门针对具有孤立DEL的MD的人（5Q）
    • immunosuppressive drugs likecyclosporine和抗杀菌细胞球蛋白（ATG），未经食品药品监督管理局（FDA）批准进行MDS治疗，但处方关闭标签在极少数情况下

支持疗法对于治疗MD也很重要。这涉及解决低血细胞计数的症状，包括：

MDS can lead to complications, particularly if it remains untreated. Complications are typically associated with low blood counts and can include:

  • 贫血由于RBC计数低
  • frequent or recurring infections，，，，which can be severe due to low WBC counts
  • 简单的bleedingthat can be hard to stop due to low platelet counts

Additionally, MDS can progress to AML in some individuals. According to the ACS, this happens in about 1 in 3 people with MDS.

MDS是一组癌症，其中骨髓中的干细胞无法正常发育。这导致未成熟细胞的增加称为爆炸，可以挤出健康的血细胞。

您拥有的MD类型以及其他因素，例如症状严重程度，某些染色体或遗传变化以及您的年龄和整体健康状况，都影响了您的前景。

MDS can cause serious complications or progress to AML, especially if it’s left untreated. See a doctor for evaluation if you develop symptoms like severe fatigue, shortness of breath, and frequent infections.