Symptoms & Causes of Aplastic Anemia & Myelodysplastic Syndromes

What are the symptoms of aplastic anemia and MDS?

The symptoms of aplastic anemia and MDS are very similar. Symptoms of the disorders may include

  • fatigue or tiredness
  • frequent infections
  • unexplained or easy bruising
  • nosebleeds, bleeding gums, or any bleeding that lasts too long
  • unusually pale skin
  • weakness
  • shortness of breath when exercising or being active
  • red or purple spots on the skin caused by bleeding under the skin
  • fast or irregular heartbeat
  • dizziness
  • fever
  • headache

Symptoms vary from person to person, depending on which type of blood cells are most affected and the cause of the disorder. In the early stages of MDS, you may have only mild symptoms or no symptoms at all.

A man rubbing his eyes while holding his eyeglasses.
Fatigue can be a symptom of aplastic anemia, MDS, and many other disorders. Medical tests may help find the cause of your tiredness.

Seek care right away

If you have a fever or bleeding that won’t stop, contact your health care professional right away. Ask your health care professional what other symptoms may need quick care. Severe aplastic anemia and higher-risk MDS, which occur when you have very low levels of one or more types of blood cells, can be life-threatening if not treated right away.

What causes aplastic anemia and MDS?

Aplastic anemia

In most cases, the exact cause of aplastic anemia is not known. This is called idiopathic. However, researchers believe that the disorder may result from the body’s own immune system causing damage to bone marrow stem cells. Certain environmental or health conditions are also associated with aplastic anemia and can trigger the disorder.

Aplastic anemia can be acquired, meaning it develops after birth, or it can be inherited, meaning it is passed down in genes from your parents. Acquired aplastic anemia is more common than the inherited disorder. With inherited aplastic anemia, it’s important that siblings also be tested for the disease so that it can be treated as early as possible.


Most cases of MDS are linked to changes to the DNA in stem cells in the bone marrow, but the exact cause is usually not known. Aging may play a role, because as you age your stem cells get older and are more likely to develop abnormalities that can lead to MDS. Certain environmental or health conditions, such as radiation and chemotherapy treatment, exposure to certain chemicals, and smoking are also associated with MDS.

Last Reviewed July 2020
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.