MDS is a group of conditions that affect new blood cell production. With MDS, blood cells in the bone marrow are abnormal, which leads to fewer healthy red blood cells, white blood cells, and platelets.

Too few red blood cells cause symptoms of anemia, such as shortness of breath and fatigue. A lack of white blood cells can also lead to more frequent infections. Having too few platelets increases the risk of bruising and bleeding.

There are six types of MDS. The types are based on which blood cells are affected and how abnormal those cells look under a microscope.

MDS is one of the most common blood cancers. Between 60,000 and 170,000 people in the United States live with this condition. Up to 20,000 people in the United States are diagnosed with MDS each year.

Experts don’t know exactly what causes MDS. The condition is more common in people who:

  • are assigned male at birth
  • are over 50 years of age
  • have had chemotherapy to treat cancer
  • have a history of smoking cigarettes, vaping nicotine, or using other tobacco products
  • have a family history of MDS or inherited conditions like Fanconi anemia or Diamond Blackfan anemia
  • have been exposed to chemicals such as benzene

A diagnosis can take time because MDS progresses slowly over many months to years. It’s also easy to mistake for leukemia.

Often, MDS doesn’t cause any symptoms in its early stages. Doctors sometimes discover low blood cell counts while doing blood tests for another reason. A bone marrow aspiration and biopsy confirm the diagnosis.

About 1 in 3 people with MDS develop acute myeloid leukemia (AML), a type of blood cancer. Your likelihood of progressing to AML depends on the type of MDS you have.

Doctors divide MDS into lower and higher-risk types based on the number of abnormal blood cells in bone marrow, as well as other factors.

Around 1 in 4 people with MDS have the high risk type. High-risk MDS is more likely to turn into AML than low risk MDS.

Racial, ethnic, and gender differences exist in MDS diagnosis and care.

A 2022 study found that non-Hispanic white people had the highest likelihood of developing MDS compared with Hispanic and Black people.

But in people under age 50, the rate of MDS was higher in Black people. Black people also had higher survival rates than Hispanic and non-Hispanic white people.

A 2023 study found sex-specific differences in genetic mutations. Sex and gender may also affect age at diagnosis and overall outlook, but more research is needed to determine whether this stems from biological or social factors.

An MDS care team includes a few different types of specialists, such as:

  • oncologists
  • hematologists
  • bone marrow transplant specialists
  • physician assistants (PAs)
  • nurse practitioners
  • nurses
  • social workers
  • dietitians

There are three main types of treatments for MDS.

Supportive care

These treatments relieve symptoms caused by low blood cell counts and help you feel better.

Supportive care includes blood transfusions and growth factors to boost blood cell counts, and antibiotics to prevent or treat infections.

Drug therapy

A few medications slow MDS progression. These include:

  • lenalidomide (Revlimid), for a specific MDS subtype (deletion 5q cytogenetic abnormality)
  • immune-suppressing medications like antithymocyte globulin (ATG)
  • azacitidine (Vidaza) and decitabine (Dacogen) to help the bone marrow make new, healthy blood cells
  • Inqovi, a pill that combines decitabine and cedazuridine, for adults with MDS

Chemotherapy with a stem cell transplant

Chemotherapy kills the abnormal blood cells in bone marrow. After chemotherapy, you get stem cells taken from your own blood or bone marrow, or from a donor’s bone marrow, to replace them.

MDS affects your body’s ability to make new, healthy red blood cells, white blood cells, and platelets.

When blood cell counts drop, symptoms like fatigue, shortness of breath, bleeding or bruising, and infections can occur.

Supportive treatments such as blood transfusions help to relieve these symptoms. Medications and stem cell transplants slow MDS by helping your body make more healthy blood cells.