Male sex and the pattern of recurrent myeloid mutations are strong independent predictors of blood transfusion intensity in patients with myelodysplastic syndromes

Rydén, Jenny; Edgren, Gustaf; Karimi, Mohsen; Walldin, Gunilla; Tobiasson, Magnus; Wikman, Agneta; Hellström‐Lindberg, Eva; Höglund, Petter

doi:10.1038/s41375-018-0256-0

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…And finally, the abstracts and poster presentations included in the study reported that transfusion dependence in patients was associated with shorter median OS vs transfusion independence (1.7 years vs 5.7 years in low‐grade MDS, P < .0001; 1.7 years vs 5.2 years in unspecified‐grade MDS, P < .0001) 24 ; TI patients at baseline had improved 1 year (66.8%) and 2 year (43.4%) OS compared with TD patients (36.4% and 22.2%, respectively; P < .001) 27 ; and transfusion rate was strongly associated with poor OS, 26 which was worse in patients receiving transfusions during the course of the disease than in those who never received a transfusion 25 …”

Section: Resultsmentioning

confidence: 94%

“…After applying the inclusion/exclusion criteria, 75 studies were excluded for containing outcomes other than OS, and 16 studies excluded due to lack of required results. The final list included ten studies for qualitative analysis: six published articles 18‐23 and four abstracts 24‐27 (Figure 1). These ten studies were added to the list of studies included by Harnan et al (2016; 12 studies) 15,28‐39 .…”

Section: Resultsmentioning

confidence: 99%

“…These ten studies were added to the list of studies included by Harnan et al (2016; 12 studies) 15,28‐39 . The total 22 studies included in the SLR are listed in Table 3 18‐39 …”

Section: Resultsmentioning

confidence: 99%

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Association between red blood cell transfusion dependence and burden in patients with myelodysplastic syndromes: A systematic literature review and meta‐analysis

Lemos

Rodrigues

Schroeder

et al. 2021

European J of Haematology

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Myelodysplastic syndromes (MDS) are a group of malignant hematologic diseases characterized by ineffective hematopoiesis, which may lead to chronic anemia and transfusion dependency, with up to 30% of patients progressing to acute myeloid leukemia (AML). Studies suggest transfusion dependency may impact overall survival (OS); however, there is a lack of evidence concerning the association between transfusion status (TS) and OS in patients with MDS who become transfusion independent (TI) after treatment. In addition, the holistic impact of TS on other clinical, economic, and humanistic outcomes has not been well understood. We conducted a systematic literature review (SLR) to understand this impact. Ten studies were included and showed consistent decrease in OS in transfusion dependent (TD) compared with TI patients. These findings were confirmed by a meta‐analysis (MA) reporting better OS prognosis for TI patients. A second SLR was conducted to understand the association between TS and other clinical, economic, and humanistic outcomes. Twenty‐eight studies were included and showed better prognosis for other outcomes, including AML progression and leukemia‐free survival for TI patients. Risk of AML progression and cumulative non‐leukemic death assessed by the MA showed a trend toward worse prognosis and higher risk of AML progression for TD patients. Lower healthcare resource utilization, better quality of life, and reduced non‐leukemic death for TI patients were observed. Studies not eligible for MA also showed better clinical, economic, and humanistic outcomes for TI patients. These findings contribute to understanding the association between transfusion dependence and OS among other outcomes in patients with MDS.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

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Association between red blood cell transfusion dependence and burden in patients with myelodysplastic syndromes: A systematic literature review and meta‐analysis

Lemos

Rodrigues

Schroeder

et al. 2021

European J of Haematology

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“…Over two‐thirds of the MDS patients require more than one RBC transfusion over the course of the disease . Considering the clinical significance of transfusion intensity, which was recently demonstrated, the negative impact on health‐related quality of life and that the direct costs of transfusions are substantial, it is important to optimize transfusion therapy to these patients.…”

Section: Methodsmentioning

confidence: 99%

A longer duration of red blood cell storage is associated with a lower hemoglobin increase after blood transfusion: a cohort study

et al. 2019

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BACKGROUND: RBC concentrates are commonly stored for up to 42 days but there has been conflicting evidence on the effect of storage duration and clinical outcomes. Most clinical studies have focused on possible associations between duration of storage time and risk for adverse outcomes, including mortality. Recent clinical trials did not find any such associations, but fewer studies have addressed whether storage time affects component efficacy. The main aim of this study was to determine the effect of RBC storage time on hemoglobin increment in transfused patients. STUDY DESIGN AND METHODS: Transfusion dataon a cohort of patients with myelodysplastic syndromes were linked to hemoglobin measurements taken between 2 days before and 28 days after a transfusion episode. We applied a mixed-effect linear regression model, accounting for patient characteristics and time from transfusion to next hemoglobin measurement, to study the effect of RBC storage on the hemoglobin increment.ABBREVIATION: MDSs = myelodysplastic syndromes.From the

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“…Studies have reported improved quality of life for patients transfused with a more liberal strategy to maintain higher hemoglobin levels [7][8][9][10], and the threshold for red blood cell transfusion should therefore be based on symptoms rather than individual hemoglobin levels [11,12]. There is ample evidence that patients dependent on erythrocyte transfusions (E-TD) at diagnosis have a shorter overall survival (OS) and that cumulative red blood cell transfusion burden and transfusion intensity also impact quality of life [13][14][15][16][17][18]. However, no studies have yet assessed if and how transfusion patterns can support key clinical decisionmaking, such as those required for stem cell transplantation.…”

Section: Introductionmentioning

confidence: 99%

Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS‐M) prediction in myelodysplastic syndromes

Creignou,

Bernard,

Gasparini

et al. 2024

J Intern Med

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BackgroundThe Molecular International Prognostic Scoring System (IPSS‐M) is the new gold standard for diagnostic outcome prediction in patients with myelodysplastic syndromes (MDS). This study was designed to assess the additive prognostic impact of dynamic transfusion parameters during early follow‐up.MethodsWe retrieved complete transfusion data from 677 adult Swedish MDS patients included in the IPSS‐M cohort. Time‐dependent erythrocyte transfusion dependency (E‐TD) was added to IPSS‐M features and analyzed regarding overall survival and leukemic transformation (acute myeloid leukemia). A multistate Markov model was applied to assess the prognostic value of early changes in transfusion patterns.ResultsSpecific clinical and genetic features were predicted for diagnostic and time‐dependent transfusion patterns. Importantly, transfusion state both at diagnosis and within the first year strongly predicts outcomes in both lower (LR) and higher‐risk (HR) MDSs. In multivariable analysis, 8‐month landmark E‐TD predicted shorter survival independently of IPSS‐M (p < 0.001). A predictive model based on IPSS‐M and 8‐month landmark E‐TD performed significantly better than a model including only IPSS‐M. Similar trends were observed in an independent validation cohort (n = 218). Early transfusion patterns impacted both future transfusion requirements and outcomes in a multistate Markov model.ConclusionThe transfusion requirement is a robust and available clinical parameter incorporating the effects of first‐line management. In MDS, it provides dynamic risk information independently of diagnostic IPSS‐M and, in particular, clinical guidance to LR MDS patients eligible for potentially curative therapeutic intervention.

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Male sex and the pattern of recurrent myeloid mutations are strong independent predictors of blood transfusion intensity in patients with myelodysplastic syndromes

Cited by 9 publications

References 15 publications

Association between red blood cell transfusion dependence and burden in patients with myelodysplastic syndromes: A systematic literature review and meta‐analysis

Association between red blood cell transfusion dependence and burden in patients with myelodysplastic syndromes: A systematic literature review and meta‐analysis

A longer duration of red blood cell storage is associated with a lower hemoglobin increase after blood transfusion: a cohort study

Early transfusion patterns improve the Molecular International Prognostic Scoring System (IPSS‐M) prediction in myelodysplastic syndromes

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