MDS: certain demographic factors prognostic of favorable survival

  • Ye X & al.
  • Hematol Oncol
  • 4 Aug 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with myelodysplastic syndrome (MDS), development of secondary acute myeloid leukemia (sAML) is associated with inferior prognosis.
  • Consideration of select demographic factors may help inform risk assessment.

Why this matters

  • sAML is responsible for up to one-half of disease-associated deaths in patients with MDS.

Study design

  • Study of outcomes in patients with MDS based on the Surveillance, Epidemiology, and End Results database.
  • Patient stratification: aged ≤40 years vs >40 years.
  • Funding: Science and Technology Department of Zhejiang Province; Medical and Health Science and Technology Plan of Zhejiang Province; Public Technology Research Projects of Yiwu, China; Key Medical Discipline of Yiwu.

Key results

  • 3.7% of younger patients and 2.5% of older patients developed sAML (P=.039); median time to transformation was 4.04 and 13.1 months, respectively (P<.001>
  • Significantly shorter median OS and median cancer-specific survival (CSS) in those who developed sAML for both age groups (all P<.001>
  • In multivariate analysis, favorable prognostic factors for OS in older patients with MDS included:
    • Female sex: adjusted HR (aHR), 0.806; 95% CI, 0.783-0.830; P<.001.>
    • Black race: aHR, 0.929; 95% CI, 0.881-0.979; P=.006.
    • Married status: aHR, 0.811; 95% CI, 0.773-0.852; P<.001.>

Limitations

  • Retrospective analysis.