Myelodysplastic syndrome (MDS), diagnosis, prognosis and the best available treatment

Myelodysplastic syndrome (MDS) is a stem cell disorder characterized by ineffective hematopoiesis and bone marrow dysplasia that, in many cases, progresses to acute myeloid leukemia [1]. Treatment for MDS is variable and applied according to the risk classification based on the International Prognostic Scoring System (IPSS) [2,3]. Approximately 10–20% of patients with myelodysplastic syndrome (MDS) present with autoimmune diseases (AD) which can be challenging to recognize. The autoimmunity is believed to be triggered by the increased apoptosis in the dysplastic bone marrow. Recent evidence suggests that both diseases are characterized by dendritic and T-cell abnormalities. AD presentation varies from clinical syndromes such as vasculitis, lupus and rheumatoid arthritis to laboratory abnormalities such as thrombocytopenia, hemolytic anemia and autoantibodies [4]. The association of AIM and MDS was first described in 1982 as AIHA one year after the diagnosis of MDS. 6 Subsequently, multiple cases and studies have been published emphasizing the relationship between autoimmunity and MDS [5].