Blood cancer is a general term used to describe many different types of cancer that affect your blood, bone marrow, or lymphatic system. Myelodysplastic syndromes (MDS) are a group of blood cancers where the bone marrow does not produce enough healthy blood cells, and myeloproliferative neoplasms (MPN) involve abnormal blood cells being produced. MDS and MPN share some features, which is why they are often talked about together.
What is myelodysplastic syndrome (MDS)?
Previously called pre-leukaemia because some patients go on to develop leukaemia, MDS is a relatively rare cancer with around 2,150 people diagnosed in the UK every year.
What is myeloproliferative neoplasm (MPN)?
MPN used to be called myeloproliferative disorder but is now classed as cancer since it involves cells being produced in an uncontrolled, malignant way. Around 4,180 people in the UK are diagnosed every year.
Although they have similarities, MDS and MPN behave differently and need different cures to reach a day when no life is cut short by them.
Is myelodysplastic syndrome curable?
For some patients, MDS is curable with a stem cell transplant, but sadly this treatment is not appropriate for everyone. MDS is a complex group of different cancers and every patient is different. If you or a loved one has been diagnosed with MDS your oncology team will advise you about your own situation.
Some people live for many years with MDS and don’t need treatment initially. For others, treatment helps to manage the condition and improve quality of life. Unfortunately around 25-30% of people with MDS will develop acute myeloid leukaemia so it is important that all patients are monitored closely for signs of this.
Advancements in science mean that more people are surviving an MDS diagnosis for longer, but more research is vital to better prevent and treat this type of cancer.
Is myeloproliferative neoplasm curable?
In most cases MPN is not curable, but treatments can help it to be managed and well controlled for years. Although it is a type of cancer, patients often feel quite well.
There are different types of MPN and if you or a loved one has been diagnosed, your treatment plan will depend on the specific type of MPN. Some types, including myelofibrosis, are harder to treat and are more likely to progress to leukaemia. Researching the different types of MPN will help find new ways to help patients worldwide.
What causes MDS and MPN?
All blood cancers are caused by changes to your DNA which make your cells grow uncontrollably. In MDS your bone marrow makes faulty blood cells and in MPN your bone marrow makes too many of a particular type of cell. Although we don’t yet fully understand the exact causes, research has helped to shine a light on the risk factors associated with MDS and MPN.
What are the known risk factors for MDS?
• Age: Around 9 in 10 MDS patients are over 50 and it is very rare in young adults and children.
• Sex: Males are more likely to develop MDS than females, and we don’t yet know why this is.
• Previous cancer treatment: Chemotherapy and radiotherapy can damage the bone marrow and increase your risk.
• Genetic disorders: Occasionally MDS is inherited or develops from another genetic disorder.
• Other blood conditions: Some other conditions, including clonal haematopoiesis of indeterminate significance, can increase your risk.
• Chemicals: Exposure to certain toxic chemicals including benzene, can increase your risk.
What are the known risk factors for MPN?
• Age: MPN is more common in older adults.
• Genetic mutations: Most MPNs are caused by a genetic mutation. The most common mutation is JAK2, but it can also be CALR or MPL. These mutations affect the growth and division of your blood cells.
• Chemicals: Exposure to benzene or ionising radiation may increase your risk.
• Family history: Occasionally MPN runs in families.
• Genetic conditions: Some other conditions increase your risk of MPN.
Can myelodysplastic syndrome and myeloproliferative neoplasm affect children?
Most cases of MDS and MPN occur in adults, but occasionally children or even infants can be affected. Juvenile myelomonocytic leukaemia (JMML) is an extremely rare type of blood cancer which is classed as both a myelodysplastic syndrome and a myeloproliferative neoplasm. This is because in JMML, too many white blood cells called monocytes and produced, and also they don't work properly.
Sadly, there are currently very few treatment options for children with JMML. However, thanks to Curestarter support, we are funding Dr Emmanuele Azzoni, who has made an exciting breakthrough about how blood cells develop, which could lead to innovative new ways to prevent or treat this devastating disease.
Symptoms, diagnosis, and treatment:
What are the symptoms of myelodysplastic syndrome and myeloproliferative neoplasm?
Some patients of MDS or MPN won’t notice any symptoms at all, particularly early on. In fact MDS and MPN are often picked up through a routine blood test rather than because of any other symptoms.
Symptoms can include feeling tired, breathlessness, bleeding more than normal, getting ill more frequently than normal or being pale. If you are worried about any possible symptoms please consult your doctor.
How are myelodysplastic syndrome or myeloproliferative neoplasm diagnosed?
To work out exactly what type of blood cancer you have, and what stage it is at, doctors may carry out a variety of tests including:
Blood tests: Blood is taken from you and sent to a lab to be tested.
Full blood count: Measures the number of each type of blood cell in your blood.
Bone marrow biopsy: Your bone marrow makes blood cells. A biopsy involves removing part of your bone marrow and looking at it under a microscope to show if it is making healthy cells.
Genetic tests: Done on cells collected from blood test or bone marrow, to look for particular genetic mutations.
Ultrasound or x-ray: Can give a picture of your tummy or chest area.
The results of these tests give doctors a better understanding of what is happening in your body, what subtype of MDS or MPN you may have and how best to treat it.
How is myelodysplastic syndrome treated?
You may not need treatment immediately because MDS often develops slowly. Your treatment plan will depend on the risk level, age and overall health. If you are in a low risk group then you may only need to have active monitoring and regular blood tests.
Patients who have higher risk MDS can receive various treatments including chemotherapy, a stem cell transplant, or immunotherapy. Although stem cell transplants can cure some patients, they are not suitable for everyone, particularly older patients, and there can be a lot of side effects.
For many MDS patients there is no cure, which is why research is so important. It is only by better understanding MDS that we can drive breakthroughs and new cures.
How is myeloproliferative neoplasm treated?
Lots of people with myeloproliferative neoplasm find that they still feel well since it tends to grow and progress slowly compared to other cancers. However there are some treatments available. These include:
Chemotherapy: Drugs can be used to control your blood cell count.
Stem cell or bone marrow transplant: Not all patients are viable candidates for a transplant but it can sometimes work as a successful cure.
Venesection: A procedure to remove some of your blood, so that your blood cell count comes down.
How do MDS and MPN relate to other blood cancers?
Both myelodysplastic syndrome and myeloproliferative neoplasm can sometimes progress to leukaemia, a more aggressive type of blood cancer, so it is always worth monitoring patients carefully to look out for signs of this. The risk of this transformation depends on the specific type of MDS or MPN and the number of regular or abnormal blood cells.
Approximately 5-10% of MPN patients will go on to develop a type of leukaemia called acute myeloid leukaemia (AML). Myelofibrosis is the most common type of MPN to progress into leukaemia.
Approximately 20-30% of people with MDS go on to develop AML. Patients can be split into different risk groups depending how quickly their MDS is developing and how likely it is to progress into leukaemia.
In high risk MDS patients, there is a higher percentage of abnormal cells in the bone marrow, there tends to be a poorer prognosis and more chance of leukaemia developing. In low risk MDS patients there are fewer abnormal bone marrow cells, a generally better prognosis and a lower chance of leukaemia. Knowing your risk group can help you get the best treatment and to help you and your family plan ahead.
Why does research matter and how can you help?
Every year thousands of people in the UK receive a diagnosis of MDS or MPN. We still don’t completely understand the causes of these diseases, and for most people there is no cure.
International cancer research like ours is the only way to answer lots of important questions such as what genetic changes are driving these blood cancers, which patients are likely to go on develop leukaemia and how to treat people who cannot tolerate a stem cell transplant.
With discovery research, scientists seek to answer questions like this and lead the way to new cures. Thanks to our Curestarters, Dr Marc Raaijmakers and his team in the Netherlands have been investigating how myelodysplastic syndrome develops in the bone marrow, so that they can find new ways to treat the disease.
More of this sort of discovery research is crucial to exploring how blood cancers like MDS and MPN are caused and how we can stop them.
Your MDS and MPN FAQs:
Is myelodysplastic syndrome a type of cancer?
Myelodysplastic syndrome (MDS) is a group of blood cancers where the bone marrow does not produce enough healthy blood cells.
Is myeloproliferative neoplasm a type of cancer?
Myeloproliferative neoplasm (MPN) is a group of blood cancers where the bone marrow produces abnormal blood cells.
Can MDS and MPN turn into leukaemia?
Yes, unfortunately both MDS and MPN can transform into acute myeloid leukaemia (AML), a more aggressive blood cancer. Approximately 5-10% of MPN patients will go on to develop AML and approximately 20-30% of people with MDS go on to develop AML.
Can younger people get MDS or MPN?
Most of the time MDS and MPN affect older adults. However, very rarely, children can receive a diagnosis. Juvenile myelomonocytic leukaemia (JMML) is a very rare type of infant cancer which is classed as both a myelodysplastic syndrome and a myeloproliferative neoplasm. Thanks to Curestarters we are working on potential new ways to help families affected by JMML.
What research is being done into myelodysplastic syndrome or myeloproliferative neoplasm?
There are at least 100 different types of blood cancer and as a cancer research charity, we are proud to support research looking for new cures into any type of blood cancer.
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