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MDS & Anemia: How they work and what you can do

Learning about the relationship between myelodysplastic syndromes (MDS) (my-el-o-dys-plastic sin-dromes) and anemia may help you better understand the disease.

What is MDS?

MDS is a group of disorders in which the bone marrow fails to make enough healthy red blood cells (RBCs), white blood cells (WBCs), or platelets (PLTs). MDS is considered a blood cancer. Bone marrow is the soft tissue found in the center of most bones and is the main place where blood cells are made.

 Icon: Bone marrow

Bone Marrow

What causes MDS?

MDS may be caused by changes to DNA called mutations. These mutations change the way the cells grow and function. With MDS, newly formed blood cells become abnormal and do not grow (mature) correctly. These abnormal blood cells do not enter your bloodstream to do their jobs. They pile up in the bone marrow instead.

The abnormal cells take up space needed for normal bone marrow function. This can lead to your body making too few mature blood cells.

The pile-up in the bone marrow keeps immature RBCs from growing into mature RBCs. With fewer mature blood cells in your body, you can develop anemia (low RBCs). You can also develop other low blood counts (cytopenias).

Icon: Mature red blood cell

Red Blood Cell (RBC)

Icon: Abnormal red blood cell


What are the 3 different types of low blood cell counts (cytopenias)?


Anemia: low red blood counts. Red blood cells help deliver oxygen to your body.


Neutropenia: low white blood counts. White blood cells are important in fighting infection in the body.


Thrombocytopenia: low platelet counts. Platelets help control bleeding inside your body and on your skin.

Icon: 9 out of 10 people who have MDS diagram

Anemia is the most common type of low blood count in people with lower-risk MDS. In fact, anemia occurs in up to 9 OUT OF 10 PEOPLE who have MDS.

What causes anemia?

For people with MDS, anemia is caused by having too few healthy, working RBCs. Working RBCs have a molecule called hemoglobin (Hgb) that carries oxygen to the organs in your body.

It might help to think of your bloodstream as a postal system:

Infographic: What causes anemia

bone marrow

Infographic: What causes anemia

red blood cells (RBC)

Infographic: What causes anemia

and oxygen (O2)

Infographic: What causes anemia

your body’s
tissues and organs


Infographic: What causes anemia

When the postal system is operating smoothly, your bone marrow is like the post office and the red blood cells are the mail carriers.


Infographic: What causes anemia

Hemoglobin are packages that are filled with oxygen. The mail carrier’s job is to deliver the packages.


Infographic: What causes anemia

In MDS-related anemia, there are not enough mail carriers to deliver the packages.


Infographic: What causes anemia

When the packages don’t get to their destination, you may feel tired, weak, forgetful, or unable to finish daily tasks.

What can anemia feel like?

There are many symptoms of anemia, and it can feel different from person to person. Some symptoms can easily be overlooked and confused with normal signs of aging, which is why it’s helpful to share how you’re feeling with your healthcare team. Speaking up helps them understand what might be causing your symptoms and can be used to create a treatment plan that works best for you.

Some common symptoms of anemia include:

  • Problems with thinking or memory
  • Feeling tired
  • Feeling weak
  • Dizziness
  • Lightheadedness
  • Headaches

Other symptoms can include:

  • Chills or cold hands and feet
  • Irregular heart rate
  • Chest pain
  • Pale or yellowish skin
  • Shortness of breath
  • Muscle cramps, bone pains, and body aches

Icon: brain, lungs and heart

These symptoms can get in the way of your daily activities. That’s why it’s important to track your anemia symptoms and speak up with your healthcare team about them.

Untreated anemia can also cause more health problems over time. For example, it may affect how well your brain, heart, and lungs work.

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When should I speak up about my anemia?

If you’re feeling any anemia symptoms. Speaking up will give your healthcare team a better idea of your current health and helps them ensure you get the treatment that’s right for you.

If you’re changing your daily routines. For example, if you’re feeling tired or unwell enough that you need a break while making the bed, or a nap after getting your mail, it’s time to talk to your healthcare team.

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