PMID: 9542325May 16, 1998Paper

Pathogenesis, etiology and epidemiology of myelodysplastic syndromes

Haematologica
Carlo AulY Yoshida

Abstract

The myelodysplastic syndromes are common hematological malignancies affecting predominantly elderly people. Patients usually present with chronic cytopenias which gradually worsen due to progressive bone marrow failure or transformation into acute myeloid leukemia. Disease prevention is more cost-effective than therapeutic intervention and the establishment of the etiology and pathogenesis of MDS therefore assumes considerable importance. This review will outline current concepts of the pathobiology of MDS, putative etiological insults and the mechanisms of disease initiation as well as recent contributions to the descriptive epidemiology of these disorders. The authors of the present review have a long-standing interest in the pathogenesis, etiology and epidemiology of MDS. Journal articles covered by the Science Citation Index and Medline have been reviewed and personal experience and discussion with international experts collated. The initiation processes for the development of MDS remain unknown. A poorly defined transforming event affects a pluripotent or multipotent progenitor cell in the bone marrow, conferring a growth advantage upon it and eventually establishing clonal hematopoiesis. An important pathogenetic mechanis...Continue Reading

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