What is myelodysplasia? A look at a little-known but potentially serious disorder

Although its name may sound complex and unfamiliar, myelodysplasia or myelodysplastic syndrome (MDS) is a blood disease that deserves greater public attention. It primarily affects people over 60, but it is not exclusive to this age group. In this article, we discuss what it is, who it affects, its symptoms, and the currently available treatments.

Myelodysplasia is a disorder of the bone marrow , the spongy tissue inside some bones that produces blood cells—red blood cells, white blood cells, and platelets. In patients with MDS, the bone marrow produces abnormal or immature cells, which affects the quality and quantity of blood cells .

In some cases, these syndromes can develop into an aggressive form of cancer: acute myeloid leukemia (AML) .

According to data from the Spanish Society of Hematology and Hemotherapy (SEHH), it is estimated that between 3 and 5 cases are diagnosed per 100,000 inhabitants in Spain each year , with a significant increase in those over 70 years of age. Although rare in young people, hereditary forms of the disease do exist.

Risk factors include previous exposure to cancer treatments (chemotherapy or radiation therapy) , certain chemicals (such as benzene), smoking, and acquired genetic mutations.

The symptoms of myelodysplastic syndrome are nonspecific and can easily be confused with other conditions , making early diagnosis difficult. The most common symptoms include:

• Persistent fatigue or weakness.
• Paleness (due to anemia).
• Frequent infections , due to low production of white blood cells.
• Easy bleeding or bruising , caused by a decrease in platelets.
• In more advanced stages, weight loss or fever without apparent cause.

Since many patients are diagnosed during routine blood tests, it is essential not to underestimate persistent symptoms and to consult a doctor.

Diagnosis is based on a complete blood count , followed by more specialized studies such as a bone marrow biopsy and genetic testing to identify specific mutations. Classification scales, such as the IPSS-R , are available to assess the severity and risk of MDS progression.

The prognosis depends on several factors: the type of cellular abnormality, the patient's age, the genetic mutations present, and the response to treatment. While some cases may progress slowly over years, others progress more rapidly.

There is no definitive cure for most patients, although some may benefit from a bone marrow transplant (especially younger patients). Current therapeutic strategies include:

• Regular blood transfusions to correct anemia.
• Bone marrow-stimulating agents , such as erythropoietin.
• Low-intensity chemotherapy .
• Hypomethylating drugs , such as azacitidine or decitabine, which help slow the progression to leukemia.
• New targeted therapies, either in the trial phase or already approved for specific subgroups.

Managing MDS requires a multidisciplinary and personalized approach, focused on improving the patient's quality of life and controlling the disease.

As precision medicine advances, specialists emphasize the importance of molecular diagnostics to personalize treatments. In recent years, research into myelodysplasia has grown, leading to improved survival rates and reduced side effects from traditional treatments.

The message is clear: although myelodysplasia is a serious disorder, early diagnosis and proper follow-up can make a big difference . Public awareness and research support are essential to advancing the fight against this silent disease.

Although its name may sound complex and unfamiliar, myelodysplasia or myelodysplastic syndrome (MDS) is a blood disease that deserves greater public attention. It primarily affects people over 60, but it is not exclusive to this age group. In this article, we discuss what it is, who it affects, its symptoms, and the currently available treatments.