[The biology of myelodysplastic syndromes]

In the past 10 years a large amount of data has been published with respect to myelodysplasia. However, this newly emerged data, to date, has not been integrated into an all encompassing cohesive concept. The more knowledge we have about this illness to more precise diagnostic classifications, prognostications and eventually curative treatment modalities are possible. The ineffective haemopoiesis that is a hallmark of the disease may be explained by the apoptosis, hence antiapoptotic therapy, it appears, in some cases results in improvement. It is known that the malfunction of the mitochondria is responsible for accumulating the iron in sideroblastic anemia. The same mitochondrial malfunction may also be a factor in the development and progression of the non-sideroblastic forms of myelodysplasia as well. Promising research is on the way in examining the interaction between stroma cells of the bone marrow and the stem cells. Several publications study the hypothesis that the stroma also plays a significant role in the development of myelodysplasia clone. This role may be a causative one or perhaps a more passive/permissive one. This paper attempts to provide an overview of the newly emerged data, published in the most recent years, concerning myelodysplasia.