Page 118 - Haematologica March 2020

Ferrata Storti Foundation
Haematologica 2020 Volume 105(3):632-639
Myelodysplastic Syndrome
Impact of red blood cell transfusion dose density on progression-free survival in patients with lower-risk myelodysplastic syndromes
Louise de Swart,1 Simon Crouch,2 Marlijn Hoeks,1,3 Alex Smith,2 Saskia Langemeijer,1 Pierre Fenaux,4 Argiris Symeonidis,5 Jaroslav Čermák,6 Eva Hellström-Lindberg,7 Reinhard Stauder,8 Guillermo Sanz,9 Moshe Mittelman,10 Mette Skov Holm,11 Luca Malcovati,12 Krzysztof Mądry,13 Ulrich Germing,14 Aurelia Tatic,15 Aleksandar Savic,16 Antonio Medina Almeida,17 Njetočka
18 19 20 Gredelj-Šimec, Agnes Guerci-Bresler, Odile Beyne-Rauzy, Dominic
21 22 4 1 Culligan, Ioannis Kotsianidis, Raphael Itzykson, Corine van Marrewijk,
Nicole Blijlevens,1 David Bowen23 and Theo de Witte,24 on behalf of the EUMDS Registry Participants
1Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands; 2Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK; 3Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands; 4Service d'Hématologie, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris and Université Paris 7, Paris, France; 5Department of Medicine, Division of Hematology, University of Patras Medical School, Patras, Greece; 6Department of Clinical Hematology, Institute of Hematology & Blood Transfusion, Praha, Czech Republic; 7Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden; 8Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria; 9Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; 10Department of Medicine A, Tel Aviv Sourasky (Ichilov) Medical Center and Sackler Medical Faculty, Tel Aviv University, Tel Aviv, Israel; 11Department of Hematology, Aarhus University Hospital, Aarhus, Denmark; 12Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy; 13Department of Hematology, Oncology and Internal Medicine, Warsaw Medical University, Warsaw, Poland; 14Department of Hematology, Oncology and Clinical Immunology, Universitätsklinik Düsseldorf, Düsseldorf, Germany; 15Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania; 16Clinic of Hematology - Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 17Department of Clinical Hematology, Hospital da Luz, Lisbon, Portugal; 18Department of Internal Medicine, Division of Hematology, Merkur University Hospital, Zagreb, Croatia; 19Service d'Hématologie, Centre Hospitalier Universitaire (CHU) Brabois Vandoeuvre, Nancy, France; 20Service de Médecine Interne, IUCT-Oncopole, CHU Toulouse, Toulouse, France; 21Department of Haematology, Aberdeen Royal Infirmary, Aberdeen, UK; 22Department of Hematology, Democritus University of Thrace Medical School, University Hospital of Alexandroupolis, Alexandroupolis, Greece; 23St. James's Institute of Oncology, Leeds Teaching Hospitals, Leeds, UK and 24Department of Tumor Immunology - Nijmegen Center for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
ABSTRACT
Progression-free survival (PFS) of patients with lower-risk myelodys- plastic syndromes (MDS) treated with red blood cell transfusions is usually reduced, but it is unclear whether transfusion dose density is an independent prognostic factor. The European MDS Registry collects prospective data at 6-monthly intervals from newly diagnosed lower-risk myelodysplastic syndromes patients in 16 European countries and Israel. Data on the transfusion dose density - the cumulative dose received at the end of each interval divided by the time since the beginning of the interval in which the first transfusion was received - were analyzed using propor- tional hazards regression with time-varying co-variates, with death and progression to higher-risk MDS/acute myeloid leukemia as events. Of the 1,267 patients included in the analyses, 317 died without progression; in 162 patients the disease had progressed. PFS was significantly associated with age, EQ-5D index, baseline World Health Organization classification, bone marrow blast count, cytogenetic risk category, number of cytopenias, and country. Transfusion dose density was inversely associated with PFS
Correspondence:
THEO DE WITTE
theo.dewitte@radboudumc.nl
Received: November 19, 2018. Accepted: June 5, 2019. Pre-published: June 6, 2019.
doi:10.3324/haematol.2018.212217
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