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About MDS

MDS are a group of disorders that affect the blood and bone marrow

Your bone marrow makes all of your blood cells

Bone marrow produces immature blood cells that typically grow into 3 types of fully functional, mature blood cells. The cell types include:

  • Red blood cells (RBCs), which transport oxygen throughout the body
  • White blood cells (WBCs), which help fight infection
  • Platelets, which help with blood clotting

Normal blood cell development

Graphic depciting normal blood cell development Graphic depciting normal blood cell development

Patients with MDS have different risk levels

Types of MDS vary from very low to high risk based on several factors. Very low- to intermediate-risk MDS is the most common type of MDS, which means that the MDS is at low risk of possibly getting worse. It is based on a prognostic score that your healthcare provider uses to help decide how to manage your MDS.

Certain types of MDS have ring sideroblasts

Ring sideroblasts are a type of immature red blood cells that are ringed with iron deposits. Ring sideroblasts are part of the diagnostic workup taken from your bone marrow or blood. Ring sideroblasts are found in certain types of disease states, including anemia associated with MDS-RS and MDS/MPN-RS-T.

How does anemia in MDS occur?

In MDS, the bone marrow does not make enough mature blood cells

This lack of mature blood cells can occur from a change to DNA in bone marrow cells, called a mutation. In MDS, your bone marrow does not totally stop working. Instead, the blood cells produced by the bone marrow do not develop correctly.

In MDS, not enough immature blood cells become mature or the blood cells may not survive as long. These immature cells are not able to enter the bloodstream. This means you have fewer mature blood cells working in the body, leading to anemia, neutropenia, and/or thrombocytopenia.

Abnormal blood cell development

Graphic depciting abnormal blood cell development Graphic depciting abnormal blood cell development

Anemia occurs in up to 90% of people who have MDS

Normally, mature red blood cells are produced through a process called erythropoiesis. When this process does not function properly, anemia may occur.

Anemia is the most common type of low blood cell count in people with lower-risk MDS, in which not enough immature red blood cells (called erythroid cells) mature into fully functional red blood cells. If you have anemia, you may feel tired, weak, or have pale skin. Your healthcare provider will measure your hemoglobin levels to help determine if you have anemia. Hemoglobin is the protein in red blood cells that carries oxygen.

Understanding anemia

Anemia occurs in patients with ‌MDS in 3 ways:

Graphic showing how anemia occurs in patients with ‌MDS in 3 ways

Why people with MDS have too few mature, working red blood cells

As stated earlier, mature red blood cells are produced through a process called erythropoiesis. In people with MDS, not enough erythroid cells are able to mature and leave the bone marrow. These erythroid cells are unable to do the job of fully working, mature red blood cells, which is to carry oxygen throughout the body.

  • When erythroid cells start to pile up in the bone marrow, they can prevent mature, working red blood cells from developing
Graphic with definition of ineffective erythropoiesis Graphic with definition of ineffective erythropoiesis

How anemia may be managed

If your anemia is severe enough, you may require red blood cell transfusions. Red blood cell transfusions add new red blood cells to your body from a donor. They temporarily replace your missing mature red blood cells and help increase hemoglobin, but do not help your body produce more red blood cells.

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