Diagnosis and Prognosis of Myelodysplastic Syndrome (MDS)
by Michael Jubinville, MPH
In some people, a problem is found during a routine blood test. Others may see their doctor when symptoms appear. The most common are feeling tired, bleeding problems, trouble breathing, or repeated infections. The doctor may think there is a blood disorder based on a physical exam, symptoms, and health past. Tests will help find a cause.
Testing for MDS
If your doctor thinks you have a blood disorder, blood tests will help find a cause. These may include:
Diagnosis of MDS
The findings from the blood tests can suggest MDS, but a bone marrow test is the only way to confirm it.
A bone marrow aspiration removes a sample of bone marrow from the bone. In most cases, the sample is taken from the hipbone. A needle is inserted through the bone. The marrow is removed with a syringe. A piece of bone may also be removed for biopsy.
Both marrow and bone sample are looked at in a lab.
Classification of MDS
If MDS is found, the results of the biopsy and new tests will help find the type. This will help to look for details of the cancer. Classification, age, and overall health help find the outlook and a plan to treat MDS.
Blood and tissue tests done in a lab help to find the type of MDS, along with other details about the disease. They will look for cell proteins and other markers such as those found in the genes. The tests will compare normal cells with cancer cells. This helps find differences between MDS and other blood cancers.
Most cancers are classified by stage. This involves where the tumor is, how big it is, or if it has spread away from the original site. MDS starts in the bone marrow, which spreads cells all over the body. Staging is not used for MDS, but it can be classified by how the bone marrow looks, how the blood cells look, and whether or not the cells have certain details present or missing.
International Prognostic Scoring System
The International Prognostic Scoring System (IPSS) is used with another system called the French-American-British classification. It is rated on these 3:
A score is given for each of the 3. The lower the score the better the outlook. The scores are added to get an IPSS score. There are 4 categories of these scores:
WHO Prognostic Scoring System
The WHO Prognostic Scoring System (WPSS) uses these 3:
The score determines 1 of these 5 groups:
General information about myelodysplastic syndromes. National Cancer Institute website. Available at: https://www.cancer.gov/types/myeloproliferative/patient/myelodysplastic-treatment-pdq#_1.
Myelodysplastic syndrome (MDS). EBSCO DynaMed Plus website. Available at:
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Myelodysplastic syndrome (MDS). Merck Manual Professional Version website Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/myelodysplastic-syndrome-mds.
Tests for myelodysplastic syndromes. American Cancer Society website. Available at: https://www.cancer.org/cancer/myelodysplastic-syndrome/detection-diagnosis-staging/how-diagnosed.html.
Last reviewed December 2020 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 3/15/2021
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