Hematopoietic function can be quite variably affect, with wide clinical features, ranging from mild anemic forms to severe BM impairment and clinical manifestations of a pre-leukemic phase. Indeed, there is now a defined classification of the various disease subtypes that are collectively included in the heterogeneous group of Myelodysplastic syndromes.

STAFF

At the IEO myelodysplastic syndromes cancers are treated by a multidisciplinary team consisting of specialists in:

• Clinical Haemato-Oncology
• Haematopathology
• New Drugs and Early Drug Development for Innovative Therapies
• Department of Pathology and Laboratory Medicine
• Department of Medical Imaging and Radiation Sciences

Risk factors for for myelodysplastic syndromes (MDS) are:

• Older people – age of 70 or 80
• Gender is more frequent for men than women Previous chemotherapy or radiation therapy
• Rare genetic syndromes
• Family history
• Smoking
• Environmental exposures
• Radiation exposure
• Exposure to cancer-causing agents , such as benzene and other chemicals

This blood cancer is quite variable, according to the different disease subtypes. Sometimes an initial form of MDS is recognized accidentally during a routine medical check or another indication, in other cases, clinical manifestation may be pronounced and rapidly worsening.

Symptoms of this blood cancer could be:

• Feeling fatigues and weak
• Difficulty in breathing on effort
• Bleeding easily
• Easily catching infections

 Main diagnostic tests are:

• Blood tests
• BM aspirate and BM biopsy: morphological examination of BM smear remain a key diagnostic tool, along with BM histological examination. In addition, several biologic investigations, including cytogenetic and molecular studies, are done on the taken samples to identify and characterize the type of MDS.

As expected, treatment varies widely, according to the type of MDS and the symptoms of the patient. So treatment can be one of the following:

• Clinical monitoring and transfusion support, when needed: blood and platelets donated from volunteers can be given to support patients and relieve the symptoms related to anemia or bleeding tendency.
• Medications: some drugs can variably induce the bone marrow to make more blood cells (hematopoietic cytokines and differentiating drugs), others are used to helping the immune system defense against microbes
• Chemotherapy: when the blood cancer becomes more aggressive, treatment with chemotherapy using regimens similar to those of acute leukemia is usually given to control the disease. New classes of chemotherapy are available to control the blood cancer with less side effects than chemotherapy are also very effective treatment options.
• Bone marrow transplant: after intensive chemotherapy, a healthy donor bone marrow cells are used to replaces the cells in the bone marrow of the patient. Allo-SCT remains a complex procedures, with morbidly and mortality risks. Usually, the procedure is considered only for younger patients, with specific clinical characteristics predicting an unfavorable outcome with non-transplant- based approaches