Pathy's Principles and Practice of Geriatric Medicine - Группа авторов

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       Domenico Fusco, Andrea Bellieni, Beatrice Di Capua, and Giuseppe Colloca

      Fondazione Policlinico Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

      The myelodysplastic syndromes (MDSs) are a heterogeneous group of malignant hematopoietic stem cell disorders characterized by cytopenia due to dysplastic and ineffective blood cell production and potential variable risk of transformation to acute leukaemia.1,2 These disorders are sporadic and arise de novo or may result after exposure to certain forms of environmental toxins (e.g. benzene), radiation (e.g. therapeutic or accidental), and chemotherapy exposure as alkylating agents (secondary MDS).3,4 MDS primarily affects older patients, with an onset mean age over 70 and an increased incidence with advancing age.5,6 The secondary MDSs are not age‐related, although they are extremely rare in children, where monocytic leukaemia can be observed. The incidence has increased over time because of the increased recognition of this disease by medical doctors, as well as the ageing of the population. The demographics in developed countries shift toward older patient populations due to increased longevity and better quality of healthcare, so more people are receiving intensive treatments like chemotherapy.

      MDS may easily be overlooked in elderly patients. It can present simply as a chronic macrocytic anaemia, and there may be a tendency to ‘leave well

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