The prospective BoHemE study is designed to evaluate the correlation between bone marrow function and skeletal health in elderly patients (>= 60 years) with or without pre-existing myelodysplastic syndromes (MDS).

Inclusion Criteria Group 1 (MDS group):

• Age ≥60 years
• With known or suspected MDS (according WHO, <20% blast count)
• Written informed consent

Inclusion Criteria Group 2 (control group):

• Age ≥60 years
• Undergoing elective knee or hip replacement therapy
• Normal blood count (defined by Hb ♀ >12 g/dL, ♂ >13 g/dL; ANC >1.8x10^9/L; PLT >100x10^9/L)
• Written informed consent

Exclusion Criteria Group 1 (MDS group) + 2 (control group):

• History of bilateral total hip replacement prior to study
• Control group only: diagnosis of MDS or AML prior to study
• Dementia defined as MMSE score of <24
• Renal insufficiency with an eGFR <30 mL/min
• Liver cirrhosis Child-Pugh B or C
• Active infection (HIV, hepatitis B or C, tuberculosis)
• Heart insufficiency NYHA III or IV or severe cardiac valve disease
• Prior allogeneic stem cell transplantation

The BoHemE study includes elderly patients (≥60 years) with or without MDS and age-related concomitant diseases.

The therapeutic management of patients is subject to current treatment recommendations and is determined solely by the attending physician. It is planned to include at least 356 patients (i. e. 178 per group) exhibiting the inclusion criteria.