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Correspondence to Author: Nicole Mioto Medeiros¹; Camilo Dias Seabra Pereira². 

1. Doctor. Graduated in Medicine from the University of Vale do Sapucaí (UNIVÁS), Pouso Alegre, Minas Gerais, Brazil. Residency in Hematology and Hemotherapy at Amaral Carvalho Hospital, Jaú, São Paulo, Brazil. Doctor at Beneficência Portuguesa Hospital in Santos, Santos, São Paulo, Brazil. Professor of Medicine at the University of Ribeirão Preto (UNAERP), Ribeirão Preto, São Paulo, Brazil.
2. Bachelor’s degree in Biological Sciences, with emphasis on Marine Biology, from Santa Cecília University. PhD in Oceanography (Biological Oceanography) from the University of São Paulo and Postdoctoral degree in Biological Oceanography from the Department of Physics and Chemistry at the University of Cádiz, Spain (2009). Currently Associate Professor in the Department of Marine Sciences at the Federal University of São Paulo (UNIFESP), at the Institute of the Sea – Baixada Santista Campus. Permanent Professor in the Interdisciplinary Graduate Programs in Marine Science and Technology (UNIFESP), Integrated Environmental Analysis (UNIFESP), and Environmental Science and Technology (UNISANTA). Collaborating Professor in the Graduate Program in Coastal Environment Biodiversity (UNESP – Litoral Paulista Campus).

DOI: 10.52338/jolr.2026.5389

Abstract:

Myelodysplastic syndrome (MDS) corresponds to a heterogeneous group of myeloid neoplasms characterized by ineffective hematopoiesis, persistent cytopenias, and variable risk of progression to acute myeloid leukemia. Evidence accumulated over time indicates that its etiology is multifactorial, involving the interaction between aging of the hematopoietic system, individual susceptibility, and environmental and occupational factors. In this scenario, chronic exposure to environmental chemical agents has emerged as an important risk factor for the development of MDS, especially in agricultural, industrial, and urban contexts. This study aimed to analyze, through a systematic review of the literature, the association between exposure to environmental chemical agents and the risk of MDS, identifying the main agents involved, the most frequent contexts of exposure, and the influence of the type and duration of exposure. The review was conducted according to PRISMA guidelines, with searches in electronic health databases using controlled descriptors and free terms related to MSD, environmental and occupational exposure, and chemical agents. After removing duplicates, studies were selected by screening titles and abstracts, followed by full-text reading, with standardized extraction of methodological and clinical data. The results demonstrated a consistent association between increased risk of MDS and prolonged exposure to pesticides and agrochemicals, herbicides, benzene, organic solvents, industrial and urban pollutants, dioxins, and other substances with genotoxic potential. Agricultural and industrial contexts were most frequently associated with risk, particularly rural and industrial workers and populations residing in environmentally contaminated areas. The duration of exposure proved to be a determining factor, since chronic and cumulative exposures were more strongly associated with the development of the disease than occasional exposures. The literature supports the biological plausibility of these associations, involving mechanisms such as DNA damage, epigenetic changes, oxidative stress, persistent inflammation, and bone marrow microenvironment dysfunction. It is concluded that exposure to environmental and occupational chemical agents is a relevant component in the etiopathogenesis of MDS, reinforcing the need for preventive strategies, occupational health surveillance, and public policies for environmental control, as well as future studies with longitudinal designs and more accurate exposure assessment.

Keywords: myelodysplastic syndrome; environmental exposure; occupational exposure; pesticides; benzene; environmental pollution; genotoxic agents; occupational health.

Citation:

Dr. Thiago Augusto Rochetti Bezerra, Environmental Chemical Agents and the Risk of Myelodysplastic Syndrome: A Systematic Review of the Literature. Journal of Leukemia Research 2026.