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Risk Factors for Myelodysplastic Syndrome (MDS)

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A risk factor is something that increases your chances of getting a disease or condition. It is possible to develop MDS with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing MDS. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.

Because bone marrow is rapidly and continuously producing new cells, it is one of the most sensitive tissues in your body. This high rate of cell production makes it susceptible to both radiation and toxic damage. Factors that may affect your risk of MDS include the following:

Exposure to Radiation

Cumulative doses of radiation increase the risk of MDS. Such radiation may be used to treat the following types of cancer:

Atomic bomb survivors, who were exposed to high doses of radiation, developed MDS at a rate 20-25 times greater than the average.

Exposure to Certain Drugs and Chemicals

Prolonged exposure to certain drugs and chemicals increases the risk of MDS:

  • Petrochemicals—chemicals derived from petroleum or natural gas, such as ethyl alcohol
  • Benzene—a distillation product from coal and petroleum that is used as a solvent and as a fuel
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  • Anticancer drugs:
    • Alkylating agents
    • Nitrosoureas
    • Etoposide
    • Fludarabine
    • Cladribine
    • Chlorambucil
    • Procarbazine

MDS may also occur in people who have taken immunosuppressive agents (for the treatment of aplastic anemia ) or granulocyte-colony stimulating factor or G-CSF (for the treatment of congenital leukopenia). However, due to the complexity of these conditions and their treatments, the relationship of MDS to these medications is not clearly defined.

Weak associations have been reported between the development of MDS and cigarette smoking and the use of hair dye, but definite causal relationships are unconfirmed.

Genetics and Birth Defects

People with certain inherited genetic defects are at a substantially greater risk of developing MDS:

  • Down’s syndrome —This is a relatively common genetic disorder that results in birth defects, medical problems, and some degree of intellectual disability.
  • Fanconi anemia—This condition is an inherited form of anemia that leads to bone marrow failure.
  • von Recklinghausen’s disease (neurofibromatosis type 1)—This is a genetic disorder of the nervous system that causes tumors to grow on the nerves in any part of the body. The condition may also produce changes in the skin and bone deformities.

Revision Information

  • Castro-Malaspina H, O’Reilly RJ. Aplastic anemia and the myelodysplastic syndromes. In: Kasper DL, Harrison TR. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

  • Silverman LR. Myelodysplastic syndrome. American Cancer Society website. Available at: http://www.nci.nih.gov/cancer%5Finformation/ . Accessed November 30, 2002.