Initial transfusion intensity predicts survival in myelodysplastic syndrome

Chan, Lap Shu Alan; Shapiro, Roman M; Buckstein, Rena; Lin, Yulia; Callum, Jeannie; Chodirker, Lisa; Lee, Christina D.; Prica, Anca; Lam, Adam; Mamedov, Alexandre; Wells, Richard A.

doi:10.3109/10428194.2013.878934

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…Benton et al 31 "history of RBC transfusion [was] significantly associated with inferior survival" Cakar et al 40 "no significant relationship was demonstrated between transfusion dependency and disease progression" Cermak et al 41 "Our results confirm a significant negative impact of transfusion dependency on survival in patients with early MDS without excess of blasts" Chan et al 42 "The intensity of transfusion required in the first few weeks after the first transfusion predicts disease severity and correlates with survival." Chee et al 43 "survival was not affected by the total number of RBC transfusions received (…) the results of the current study also suggest limited morbidity from iron overload in patients with RARS."…”

Section: Survivalmentioning

confidence: 66%

“…Fourteen studies reported data on survival following diagnosis of MDS in relation to transfusion frequency, dependency and/or cumulative burden. 8,14,15,18,26,[29][30][31][40][41][42][43][44][45] The majority reported an inverse relationship between RBC transfusion and survival. Seven studies demonstrated poorer overall survival associated with transfusion dependency 8,14,15,18,26,31,41 and four reported that greater transfusion intensity was associated with decreased overall survival 29,30,42 and/or leukaemia-free survival.…”

Section: Survivalmentioning

confidence: 99%

“…8,14,15,18,26,[29][30][31][40][41][42][43][44][45] The majority reported an inverse relationship between RBC transfusion and survival. Seven studies demonstrated poorer overall survival associated with transfusion dependency 8,14,15,18,26,31,41 and four reported that greater transfusion intensity was associated with decreased overall survival 29,30,42 and/or leukaemia-free survival. 29,30,42,45 Only three studies found no significant differences in overall survival in MDS patients who received a greater number of RBC transfusions, 40,43,44 among which one report focused exclusively on MDS patients undergoing allogeneic haematopoietic cell transplantation in whom prior RBC transfusion burden was a predictor of poorer relapsefree survival.…”

Section: Survivalmentioning

confidence: 99%

“…Seven studies demonstrated poorer overall survival associated with transfusion dependency 8,14,15,18,26,31,41 and four reported that greater transfusion intensity was associated with decreased overall survival 29,30,42 and/or leukaemia-free survival. 29,30,42,45 Only three studies found no significant differences in overall survival in MDS patients who received a greater number of RBC transfusions, 40,43,44 among which one report focused exclusively on MDS patients undergoing allogeneic haematopoietic cell transplantation in whom prior RBC transfusion burden was a predictor of poorer relapsefree survival. 44 T A B L E 2 Authors' conclusions on red blood cell transfusion in patients with myelodysplastic syndromes Author Transfusion-related conclusion Alessandrino et al 8 "Pre-transplantation transfusion history and serum ferritin have significant prognostic value in patients with myelodysplastic syndrome undergoing myeloablative allogeneic stem cell transplantation, inducing a significant increase of non-relapse mortality."…”

Section: Survivalmentioning

confidence: 99%

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Red blood cell transfusion in myelodysplastic syndromes: A systematic review

Kaka

Jahangirnia

Beauregard

et al. 2021

Transfusion Medicine

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Patients with myelodysplastic syndrome (MDS) frequently receive red blood cell (RBC) transfusions for anaemia resulting from ineffective erythropoiesis. While RBC transfusions may rapidly increase haemoglobin values, their impact on clinical and health services outcomes in MDS patients has not previously been summarized. We conducted a systematic review of the literature to evaluate risks and benefits of RBC transfusions in MDS patients. We searched electronic databases (MEDLINE, Embase, CENTRAL, CINAHL) from inception through June 4, 2021 to identify studies reporting data on RBC transfusions in MDS patients. Full text publications that assessed RBC transfusions as an intervention and reported at least one clinical, laboratory, or healthcare outcome associated with transfusion were included. Study characteristics, transfusion information and transfusion-related outcomes were extracted and reported. We identified 1243 original studies, of which 38 met eligibility requirements and were included.Fourteen reported on survival following diagnosis of MDS, with the majority reporting poorer survival among patients receiving or requiring more frequent transfusions. Nine reported on transfusion-related iron overload and its complications. Other outcomes included rates of allo/autoimmunization and adverse transfusion reactions, and healthcare costs incurred by patients with a greater transfusion burden. Only two studies reported on symptom relief following transfusion. This review underscores transfusion dependence as a negative prognostic factor for MDS patients and highlights the paucity of evidence surrounding quality of life and symptom-related outcomes following RBC transfusions in this population. Further study of patient-important outcomes associated with transfusion in MDS patients is warranted to improve therapeutic recommendations and inform resource allocation.

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Section: Survivalmentioning

confidence: 66%

Section: Survivalmentioning

confidence: 99%

Section: Survivalmentioning

confidence: 99%

Section: Survivalmentioning

confidence: 99%

See 2 more Smart Citations

Red blood cell transfusion in myelodysplastic syndromes: A systematic review

Kaka

Jahangirnia

Beauregard

et al. 2021

Transfusion Medicine

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“…Although patients also suffer from an increased risk of infection or hemorrhage and may even progress to acute myeloid leukemia (AML), anemia is the most common form of cytopenia in MDS [2]. To overcome anemia, patients with MDS require chronic RBC transfusions [3], often resulting in iron overload [4,5], which is reflected by high serum ferritin (SF) levels.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Literature Review of the Relationship between Serum Ferritin and Outcomes in Myelodysplastic Syndromes

Olíva

Huey

Deshpande

et al. 2022

JCM

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Anemia is the most common form of cytopenia in patients with myelodysplastic syndromes (MDS), who require chronic red blood cell transfusions and may present high serum ferritin (SF) levels as a result of iron overload. To better understand the potential effects of high SF levels, we conducted a systematic literature review (SLR) to identify evidence on the relationship between SF levels and clinical, economic, or humanistic outcomes in adult patients with MDS. Of 267 references identified, 21 were included. No studies assessing SF levels and their relationship with humanistic or economic outcomes were identified. Increased SF levels were an indicator of worse overall survival and other worsened outcomes; however, the association was not consistently significant. SF levels were a significant prognostic factor for relapse incidence of MDS and showed a significant positive correlation with number of blood units transfused but were not associated with progression to acute myeloid leukemia or the time to transformation. Higher SF levels were also an indicator of a lower likelihood of leukemia-free survival, relapse-free survival, and event-free survival. The SLR suggests that SF levels are associated with clinical outcomes in MDS, with higher levels correlated with number of blood units transfused, frequently indicating worse outcomes.

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Patterns of treatment and costs associated with transfusion burden in patients with myelodysplastic syndromes

DeZern

Binder²,

Rizvi³

et al. 2017

Leukemia & Lymphoma

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Transfusion dependence (TD) among myelodysplastic syndromes (MDS) patients negatively impacts survival and health-related quality of life. We evaluated cost patterns of MDS care during TD and transfusion independence (TI). MDS patients were identified from a US claims database (2008-2013). TD was defined as ≥2 consecutive 8-week periods with ≥1 claim during each, and no interim 56-day period without transfusion; TI as 8 subsequent transfusion-free weeks; and transfusion frequency as the mean interval between transfusions during the TD period. 13,741 patients were included; 19% were TD and 70% had a mean interval between transfusions of ≤28 days. During a 2-year period, TD patients incurred a mean total cost of $17,815/patient-month; 53% higher for those with ≤28 days ($19,498) vs. >28 days ($12,717) between transfusions. Among patients who achieved TI, mean total cost was $7874/patient-month. For TD-MDS patients, cost increases are proportional to transfusion frequency and achieving TI yields economic benefits.

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Initial transfusion intensity predicts survival in myelodysplastic syndrome

Cited by 5 publications

References 21 publications

Red blood cell transfusion in myelodysplastic syndromes: A systematic review

Red blood cell transfusion in myelodysplastic syndromes: A systematic review

A Systematic Literature Review of the Relationship between Serum Ferritin and Outcomes in Myelodysplastic Syndromes

Patterns of treatment and costs associated with transfusion burden in patients with myelodysplastic syndromes

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