Differences in epidemiology of MDS between Western and Eastern countries: Ethnic differences or environmental influence?

Myelodysplastic syndromes show ethnic differences. Several investigators have reported a striking difference in age at diagnosis between Eastern and Western MDS patients. Referring to a letter bei Paydas speculating about toxic environmental influences as a possible cause for younger age in Asian MDS patients, we discuss our experience from a direct comparison of Japanese and German MDS, in particular refractory anemia patients.