Myelodysplastic Syndromes

Key facts

• Myelodysplastic syndromes (MDS) are a group of bone marrow disorders in which blood cell production goes wrong, leaving too few healthy red cells, white cells, or platelets.
• They're more common after age 60 and range from slow-progressing disease managed with supportive care to more aggressive forms that can transform into acute leukaemia.
• Treatment depends on risk category: growth factors or transfusions for low-risk disease, disease-modifying therapy such as lenalidomide for higher-risk or specific subtypes.
• Persistent fatigue, recurrent infections, or unusual bruising deserve prompt investigation rather than a wait-and-see approach.

What goes wrong in MDS

Healthy bone marrow continuously replaces worn-out blood cells. In MDS, mutations inside the marrow's stem cells disrupt that process. The faulty cells crowd the marrow without maturing properly, building up immature blast cells instead of healthy ones. The result is anaemia, which causes fatigue and breathlessness, a higher infection risk from low white cell counts, and easy bruising or bleeding as platelet numbers fall. Symptoms can stay subtle for years before a routine blood test turns up abnormal counts.

How MDS is treated

Treatment depends on the risk category assigned at diagnosis. Low-risk disease may be managed with growth factors or blood transfusions alone, without disease-modifying drugs. Higher-risk MDS more often calls for treatment that targets the disease itself: lenalidomide is used in specific subtypes, particularly those with a chromosome 5q deletion, where it can meaningfully reduce how often a patient needs transfusions. For eligible patients, a stem cell transplant remains the only option that can potentially cure the disease. Wider treatment options sit within the oncology category.

When to see a doctor

Unexplained persistent fatigue, recurrent infections, or unusual bruising warrants prompt investigation. MDS is usually caught through blood tests ordered for these symptoms, so don't dismiss them as ordinary tiredness or ageing.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.