The risk factors for developing MDS include the following:

• Age – MDS affects older people, and 93 per cent of all those diagnosed are over the age of 60.
• Gender – MDS is more common in males than females.
• Exposure to environmental/occupational hazards – long-term exposure to benzene, tobacco smoke, insecticides, radiation and other toxins may increase the risk of developing MDS.
• Previous chemotherapy or radiation treatment – treatment using alkylating agents and purine analogues, radiotherapy or ionising radiation may increase the risk of developing secondary MDS.
• An inherited predisposition to MDS is seen in one-third of paediatric MDS patients, including Down syndrome, Fanconi’s anaemia and neurofibromatosis. Work-up for such inherited syndromes may be considered when reviewing a young patient with MDS.