Legendary Indian actor Amrish Puri, remembered for iconic performances in films like Mr. India, died on January 12, 2005, at the age of 72 after battling Myelodysplastic Syndrome (MDS), a rare but serious blood disorder that affects the bone marrow’s ability to produce healthy blood cells.

His illness drew public attention to Myelodysplastic Syndrome, a complex hematologic disorder that primarily affects older adults and can lead to life-threatening complications, including progression to leukemia. While relatively uncommon compared to other blood diseases, MDS remains an important condition for clinicians to recognize due to its increasing incidence among aging populations.

Puri’s son, Rajeev Puri, in a previous interview, spoke about the actor’s health struggles and the circumstances surrounding the diagnosis. According to him, the illness was detected around 2003, after the actor experienced weakness and a reduced appetite.

Rajeev Puri recalled that his father had suffered a serious accident during the shooting of the film Jaal: The Trap in Himachal Pradesh, which caused injuries to his face and eyes and required blood transfusions. In the years that followed, he developed Myelodysplastic Syndrome.

Despite the diagnosis, Amrish Puri remained determined to continue working. His son shared that the actor insisted on completing all his pending films even while dealing with illness and physical pain.

Rajeev Puri said his father tried to maintain a positive outlook during his illness. When asked about his health, the actor would often respond simply:

Myelodysplastic Syndrome (MDS) is a group of disorders in which the bone marrow produces abnormal or poorly functioning blood cells. Instead of generating healthy red blood cells, white blood cells, and platelets, the bone marrow produces defective cells that fail to perform their normal functions.

MedBound Times connected with Dr. Rajendra Ankushe, Prof. & Head, Department of Community Medicine, Government Medical College, Parbhani, according to him:

Because MDS affects blood cell production, patients often experience symptoms related to anemia, infections, and abnormal bleeding.

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Doctors classify Myelodysplastic Syndrome based on whether a clear cause can be identified.

Primary (Idiopathic) MDS

In many patients, doctors cannot determine a specific cause. These cases are categorized as idiopathic or primary MDS.

Secondary MDS

Secondary MDS occurs due to exposure to certain environmental or medical factors, including:

• Exposure to industrial chemicals such as benzene

• Radiation exposure

• Smoking

• Environmental toxins

• Previous treatment with chemotherapy or radiotherapy

These exposures can damage bone marrow cells and disrupt normal blood formation.

Certain factors increase the risk of developing Myelodysplastic Syndrome, particularly among older individuals.

Major risk factors include:

• Age above 60 years

• Smoking

• Occupational exposure to chemicals

• Previous chemotherapy or radiation therapy

Because age is one of the strongest risk factors, most cases of MDS are diagnosed after the age of 60.

The underlying mechanism of Myelodysplastic Syndrome involves genetic abnormalities that affect hematopoiesis, the process by which the bone marrow produces blood cells.

Key changes include:

• Genetic defects that impair normal blood cell formation

• Dysplastic blood cell formation, meaning the cells develop abnormally

• Hypercellular bone marrow, where the marrow contains many cells but still fails to produce healthy, functional blood cells

As a result, patients develop low levels of functioning red blood cells, white blood cells, and platelets.

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Some individuals with Myelodysplastic Syndrome remain asymptomatic and are diagnosed during routine laboratory tests.

However, many patients develop symptoms due to low blood cell counts.

Common symptoms include:

• Easy fatigability

• Breathlessness

• Pallor caused by anemia

• Recurrent infections

• Bleeding or bruising

• Petechiae (tiny red or purple spots on the skin)

These symptoms occur because the body lacks adequate healthy blood cells.

Doctors diagnose Myelodysplastic Syndrome through blood tests and bone marrow examination.

Complete Blood Count (CBC)

A CBC test may reveal:

• Anemia

• Neutropenia (low white blood cells)

• Thrombocytopenia (low platelets)

• Sometimes thrombocytosis (increased platelets)

Bone Marrow Examination

A bone marrow test typically shows:

• Dysplastic hematopoietic cells

• Increased blast cells

• Abnormal blood cell development

These findings help confirm the diagnosis and evaluate the risk of disease progression.

When asked “Why is awareness about rare blood disorders like Myelodysplastic Syndrome important, especially among older adults?”, Dr. Rajendra Ankushe offered a broader public health perspective.

He stated:

According to his family, Puri completed several films despite declining health before suffering a fall at home that led to a massive brain haemorrhage, which ultimately resulted in his death in January 2005.