Defining the Epidemiology of Myelodysplastic syndromes (MDS)

Background: The myelodysplastic syndromes (MDS) include a diverse group of diseases in which the production of blood cells by the bone marrow is disrupted. There has been a Renaissance over the past decade in our understanding of the pathobiology and therapeutic options of MDS. In spite of this, little is known about the epidemiology, including population variations and risk factors of MDS. Our goal was to summarize the published literature concerning the epidemiology of MDS.

Methods: A narrative review of published literature was conducted, identifying and summarizing key reports that describe the occurrence of MDS in populations and factors that affect MDS risk.

Results: Different classification systems are used to distinguish subtypes and guide treatment, which is not very effective. There is a difference of MDS incidence in different populations. We identified the role of demographics (age, gender, race, and geographic variation), genetic factors, environmental/occupational exposures, life-style factors, and treatment for other cancers in MDS risk. Finally, we proposed an etiological model.

Conclusions: MDS survival is poor, especially after transforming to acute myelogenous leukemia (AML). Age, gender and race are established risk factors for MDS. Smoking and alcohol consumption are two major life-style risk factors that have been intensively studied over the past decades, but the results are still inclusive. A meta-analysis is proposed to further look at this association. New researches now focus on investigating inflammatory pathways and identifying biomarkers.