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Why Anemia is Common in MDS
Myelodysplastic syndromes (MDS) is a group of disorders characterized by abnormal blood cell production and changes in the bone marrow. Anemia is one of the most significant indicators of MDS, affecting approximately 85% of patients at diagnosis.
The main cause of MDS anemia is an inadequate production of functional red blood cells. However, anemia can arise from multiple causes, including genetic mutations, alterations, nutritional deficiencies, and environmental factors within the bone marrow. These causes also affect the normal production of red blood cells.
Recently, at one of our HealthTree webinars, we featured MDS expert Dr. Christopher Benton who explained how anemia is assessed in MDS patients and answered all participants’ questions while teaching a comprehensive overview of anemia treatments.
Types of Anemia in MDS
Depending on the cause, there are several different types of anemia.
Anemia is evaluated through a microscopic view of the red blood cells, and diagnosed by a blood test examining blood cell counts, morphologic characteristics, and hemoglobin levels.
A bone marrow biopsy can also provide important information to diagnose anemia and help determine the cause. Anemia types are classified according to the size and shape of the red blood cells and whether they perform the regular functions of a red blood cell (oxygen and iron transportation).\
|
Anemia Type |
Characteristics |
|
Normocytic Anemia |
Occurs when red blood cells are of normal size but are insufficient in number. |
|
Macrocytic Anemia |
Has abnormally large red blood cells, is more common in MDS. This type of anemia is typically associated with an increased size in red blood cells and variations in red blood cell size. |
|
Dimorphic Anemia |
Dimorphic means two shapes, this anemia type involves both large and small red blood cells, which is a sign of abnormal production. |
|
Iron-Transport Deficiency Anemia |
This results from the inability to transport iron effectively to developing red blood cells. Genetic mutations affecting iron metabolism can cause this. |
|
Refractory Anemia with Ring Sideroblasts |
Is a distinct subtype of anemia seen in some MDS patients.
It is characterized by red blood cell precursors that contain abnormal iron deposits, known as ring sideroblasts. It’s often associated with iron overload in developing red blood cells and typically presents with normal white blood cell and platelet counts. |
|
Anemia Associated with Other Cytopenias |
MDS patients often experience other cytopenias (low blood cell counts), such as leukopenia (low white blood cell count) and thrombocytopenia (low platelet count). These conditions result from the bone marrow's inability to produce healthy blood cells, leading to an increased risk of infections, bleeding, and bruising. |
What Are Anemia Symptoms?
Anemia symptoms can significantly affect a person’s quality of life, limiting daily activities and contributing to emotional and psychological distress. Common symptoms include fatigue, weakness, dizziness, shortness of breath, and an increased susceptibility to infections.
How is Anemia Treated?
Managing anemia in MDS patients remains a subject of ongoing research and debate since recent studies have demonstrated that some treatments are better for different risk statuses and some treatments, like transfusions, when long-term are not as beneficial as intended, for example, being transfusion-dependent can be associated with a worse prognosis.
Treatments may include:
- Erythropoiesis-stimulating agents (ESAs): such as epoetin or darbapoietin can help stimulate red blood cell production in some lower-risk patients, although their effectiveness varies.
- Blood transfusions: 94% of patients with MDS reportedly receive transfusions due to anemia. While transfusions can temporarily relieve anemia-related symptoms, they also carry risks such as iron overload and immune complications.
- Iron chelation therapy: In patients requiring frequent transfusions, this therapy may help prevent complications associated with excessive iron accumulation.
- Disease-modifying therapies: Some patients may benefit from treatments targeting the underlying disease, such as hypomethylating agents or bone marrow transplantation.
- Specific medications to treat anemia in MDS: recent studies have shed light on therapies with luspatercept and imetelstat.
Despite these available treatments, concerns remain regarding their long-term impact and potential complications. Research efforts continue to focus on developing targeted therapies that address anemia in MDS to improve patient outcomes.
Supportive Measures for Anemia
Other measures do not involve medications and focus on helping the body create healthy new red blood cells. Nutrition, such as diet and supplements, is a pillar for providing iron, folates, and vitamins (especially vitamins B12, and B6) that aid the new red blood cells in having all their components.
Other supportive measures can be maintaining an active life. Rather than resting while feeling fatigued, physical activity can improve this symptom and energize the body.
Final Thoughts
Anemia in myelodysplastic syndromes is a complex condition resulting from multiple factors. It significantly affects patients' quality of life and requires a comprehensive approach to management. Advancements in understanding the mechanisms of anemia in these disorders are essential for developing more effective treatments and improving outcomes for affected individuals.
Keep Reading More HealthTree Articles About Anemia in MDS
At HealthTree, we care about patient empowerment through education, that’s why we cover comprehensive articles with the latest treatment updates here:
- Low-Risk MDS Patients See Limited Benefit from Traditional Anemia Treatment (ESAs)
- Spotlight on Anemia and Transfusion Independence
- Anemia Treatment for Lower-Risk MDS Receives FDA Orphan Drug Designation
- Aplastic Anemia and Myelodysplastic Syndromes: Similarities and Differences
- Transfusion-Dependent MDS Patients
Sources:
Myelodysplastic syndromes (MDS) is a group of disorders characterized by abnormal blood cell production and changes in the bone marrow. Anemia is one of the most significant indicators of MDS, affecting approximately 85% of patients at diagnosis.
The main cause of MDS anemia is an inadequate production of functional red blood cells. However, anemia can arise from multiple causes, including genetic mutations, alterations, nutritional deficiencies, and environmental factors within the bone marrow. These causes also affect the normal production of red blood cells.
Recently, at one of our HealthTree webinars, we featured MDS expert Dr. Christopher Benton who explained how anemia is assessed in MDS patients and answered all participants’ questions while teaching a comprehensive overview of anemia treatments.
Types of Anemia in MDS
Depending on the cause, there are several different types of anemia.
Anemia is evaluated through a microscopic view of the red blood cells, and diagnosed by a blood test examining blood cell counts, morphologic characteristics, and hemoglobin levels.
A bone marrow biopsy can also provide important information to diagnose anemia and help determine the cause. Anemia types are classified according to the size and shape of the red blood cells and whether they perform the regular functions of a red blood cell (oxygen and iron transportation).\
|
Anemia Type |
Characteristics |
|
Normocytic Anemia |
Occurs when red blood cells are of normal size but are insufficient in number. |
|
Macrocytic Anemia |
Has abnormally large red blood cells, is more common in MDS. This type of anemia is typically associated with an increased size in red blood cells and variations in red blood cell size. |
|
Dimorphic Anemia |
Dimorphic means two shapes, this anemia type involves both large and small red blood cells, which is a sign of abnormal production. |
|
Iron-Transport Deficiency Anemia |
This results from the inability to transport iron effectively to developing red blood cells. Genetic mutations affecting iron metabolism can cause this. |
|
Refractory Anemia with Ring Sideroblasts |
Is a distinct subtype of anemia seen in some MDS patients. It is characterized by red blood cell precursors that contain abnormal iron deposits, known as ring sideroblasts. It’s often associated with iron overload in developing red blood cells and typically presents with normal white blood cell and platelet counts. |
|
Anemia Associated with Other Cytopenias |
MDS patients often experience other cytopenias (low blood cell counts), such as leukopenia (low white blood cell count) and thrombocytopenia (low platelet count). These conditions result from the bone marrow's inability to produce healthy blood cells, leading to an increased risk of infections, bleeding, and bruising. |
What Are Anemia Symptoms?
Anemia symptoms can significantly affect a person’s quality of life, limiting daily activities and contributing to emotional and psychological distress. Common symptoms include fatigue, weakness, dizziness, shortness of breath, and an increased susceptibility to infections.
How is Anemia Treated?
Managing anemia in MDS patients remains a subject of ongoing research and debate since recent studies have demonstrated that some treatments are better for different risk statuses and some treatments, like transfusions, when long-term are not as beneficial as intended, for example, being transfusion-dependent can be associated with a worse prognosis.
Treatments may include:
- Erythropoiesis-stimulating agents (ESAs): such as epoetin or darbapoietin can help stimulate red blood cell production in some lower-risk patients, although their effectiveness varies.
- Blood transfusions: 94% of patients with MDS reportedly receive transfusions due to anemia. While transfusions can temporarily relieve anemia-related symptoms, they also carry risks such as iron overload and immune complications.
- Iron chelation therapy: In patients requiring frequent transfusions, this therapy may help prevent complications associated with excessive iron accumulation.
- Disease-modifying therapies: Some patients may benefit from treatments targeting the underlying disease, such as hypomethylating agents or bone marrow transplantation.
- Specific medications to treat anemia in MDS: recent studies have shed light on therapies with luspatercept and imetelstat.
Despite these available treatments, concerns remain regarding their long-term impact and potential complications. Research efforts continue to focus on developing targeted therapies that address anemia in MDS to improve patient outcomes.
Supportive Measures for Anemia
Other measures do not involve medications and focus on helping the body create healthy new red blood cells. Nutrition, such as diet and supplements, is a pillar for providing iron, folates, and vitamins (especially vitamins B12, and B6) that aid the new red blood cells in having all their components.
Other supportive measures can be maintaining an active life. Rather than resting while feeling fatigued, physical activity can improve this symptom and energize the body.
Final Thoughts
Anemia in myelodysplastic syndromes is a complex condition resulting from multiple factors. It significantly affects patients' quality of life and requires a comprehensive approach to management. Advancements in understanding the mechanisms of anemia in these disorders are essential for developing more effective treatments and improving outcomes for affected individuals.
Keep Reading More HealthTree Articles About Anemia in MDS
At HealthTree, we care about patient empowerment through education, that’s why we cover comprehensive articles with the latest treatment updates here:
- Low-Risk MDS Patients See Limited Benefit from Traditional Anemia Treatment (ESAs)
- Spotlight on Anemia and Transfusion Independence
- Anemia Treatment for Lower-Risk MDS Receives FDA Orphan Drug Designation
- Aplastic Anemia and Myelodysplastic Syndromes: Similarities and Differences
- Transfusion-Dependent MDS Patients
Sources:
about the author
Jimena Vicencio
Jimena is an International Medical Graduate and a member of the HealthTree Writing team. She has a passion for learning new things and is currently learning Japanese and pursuing a bachelor's degree in journalism. In her free time, she loves riding her bike, swimming, and playing with her two rescued kitties.
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