The MDS Beacon™

In this edition of his quarterly column, Dr. Steensma answers the question, Where does the name myelodysplastic syndromes come from? The column will be published as a two-part series. In Part 1, Dr. Steensma described the history of the disease name. In Part 2 (below), he addresses the origins of the name.

So what is the etymology (word history) of “myelodysplastic syndromes?”

To begin with, “myelo-“ has as its origin the Greek word μυελός, meaning “marrow.”  Interestingly, there are also a number of terms related to the spinal cord that use the myelo- prefix.  For example, there is “myelitis,” an inflammatory condition of the spinal cord, and there is a type of congenital malformation of the spinal column that is confusingly called “myelodys­plasia.”

That is because some of the early Greek anatomists more than 2000 years ago believed (incorrectly) that the spinal cord – part of the central nervous system – was just a peculiar type of bone marrow, since it is encased in bone just like other marrow. They didn’t really understand the nature of blood as a liquid tissue full of cells and certainly did not know anything about the role of the bone marrow in producing in blood cells.

“-dys-,“ from the Greek δυσ, refers to anything that is bad, difficult, or (dis)ordered.  We see this dys- root in many English terms: dysfunctional, dysphoric, or dyslexic (i.e., difficulty reading). When used to describe MDS, the “dys” means failure to produce normal healthy blood cells.

“-plastic,” in turn, comes from πλαστική – another Greek root – and carries a sense of the process of formation or molding.

Although for most of us the word “plastic” suggests the plastic materials used for making automobile parts or inexpensive children’s toys, which were famously discussed as the “wave of the future” during a poolside scene in the 1968 Dustin Hoffman film “The Graduate,” the term plastic has a much broader meaning.  “Plastic surgery,” for example, is molding of the human flesh; the plastic materials used to make Fisher-Price telephones or Chevrolet taillights are not used to perform tummy-tucks, chin lifts, or breast augmentation.

Putting myelo-, -dys-, and –plastic together as “myelodysplastic” means that when looking at the bone marrow under the microscope, the marrow appears abnormal, and that abnormal-appearing marrow also forms abnormal cells. This is an accurate description of our current understanding of MDS.

Finally, we can briefly consider what the term “syndrome” adds (the recent trend is to use “syndromes” to refer to MDS instead of “syndrome” to reflect the diversity of these conditions).  Here we find yet two more Greek roots.

First, “syn-“ comes from the Greek σύν, meaning “together” or “with.”  The same root is used in many “togetherness” terms like synesthesis, synagogue, symphony, and sympathy.

“-drome,” in turn, comes from δρόμος and means “course,” “road,” or “walking.” A “syn-drome,” then, is several things that walk or move together, or are found together.

In the medical sense, a syndrome is collection of several clinically recognizable disease features that are often found together in the same patient at the same time, including symptoms reported by patients (e.g., fatigue), physical signs observed by physician during examination of the body (e.g., paleness or racing heart), and results of laboratory tests (e.g., low hemoglobin level, meaning anemia.).

Syndromes often lack a clear cause, which certainly describes most cases of myelodysplastic syndromes, where the origin is not yet known.

Many syndromes are named either after the first patient described with the disorder or the physician who first described it. Examples include Down Syndrome, caused by an extra copy of chromosome 21 and named after physician John Langdon Down, and Edwards Syndrome (Edwards Syndrome does not refer to cheating on your wife during a Presidential political campaign, but instead to having an extra copy of chromosome 18).

The term syndrome is also often used facetiously to describe things that are not medical disorders at all, such as Depleted Mother Syndrome, Black Friday Shopping Syndrome, or Political Misery Syndrome.

The term “myelodysplastic syndromes” has evolved through a century of observations of blood and bone marrow and it describes a group of disorders in which the bone marrow fails to produce an adequate number of healthy blood cells, of unclear cause.

This is a pretty good description, and although the term may sound excessively technical to some, it conveys a lot of information to those who are aware of the word origin or its component parts.

Dr. David Steensma is a physician at the Dana-Farber Cancer Institute in Boston and an Associate Professor in the Department of Medicine at Harvard Medical School. His primary area of research focuses on myelodysplastic syndromes and related conditions.