Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome
Jazyk angličtina Země Anglie, Velká Británie Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
27926979
PubMed Central
PMC5596334
DOI
10.1111/joim.12579
Knihovny.cz E-zdroje
- Klíčová slova
- MDS, Myelodysplasia, anaemia, haematology, haemoglobin,
- MeSH
- časové faktory MeSH
- dospělí MeSH
- hematinika terapeutické užití MeSH
- krevní transfuze * MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- mladiství MeSH
- mladý dospělý MeSH
- myelodysplastické syndromy mortalita terapie MeSH
- následné studie MeSH
- progrese nemoci MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- hematinika MeSH
BACKGROUND: The EUMDS registry is an unique prospective, longitudinal observational registry enrolling newly diagnosed patients with lower-risk myelodysplastic syndrome (MDS) from 17 European countries from both university hospitals and smaller regional hospitals. OBJECTIVE: The aim of this study was to describe the usage and clinical impact of erythropoiesis-stimulating agents (ESAs) in 1696 patients enrolled between 2008 and 2014. METHODS: The effects of ESAs on outcomes were assessed using proportional hazards models weighting observations by propensity to receive ESA treatment within a subset of anaemic patients with or without a regular transfusion need. RESULTS: ESA treatment (median duration of 27.5 months, range 0-77 months) was administered to 773 patients (45.6%). Outcomes were assessed in 897 patients (484 ESA treated and 413 untreated). ESA treatment was associated with a nonsignificant survival benefit (HR 0.82, 95% CI: 0.65-1.04, P = 0.09); this benefit was larger amongst patients without prior transfusions (P = 0.07). Amongst 539 patients for whom response to ESA treatment could be defined, median time to first post-ESA treatment transfusion was 6.1 months (IQR: 4.3-15.9 months) in those transfused before ESA treatment compared to 23.3 months (IQR: 7.0-47.8 months) in patients without prior transfusions (HR 2.4, 95% CI: 1.7-3.3, P < 0.0001). Responding patients had a better prognosis in terms of a lower risk of death (HR 0.65, 95% CI: 0.45-0.893, P = 0.018), whereas there was no significant effect on the risk of progression to acute myeloid leukaemia (HR 0.71, 95% CI: 0.39-1.29, P = 0.27). CONCLUSION: Appropriate use of ESAs can significantly delay the onset of a regular transfusion need in patients with lower-risk MDS.
Clinique Universitaire d'hématologie CHU de Grenoble Université Grenoble Grenoble France
Department of Clinical Hematology Institute of Hematology and Blood Transfusion Praha Czech Republic
Department of Hematology Hospital Universitario y Politécnico La Fe Valencia Spain
Department of Hematology Radboud university medical center Nijmegen the Netherlands
Department of Internal Medicine 5 Innsbruck Medical University Innsbruck Austria
Department of Medicine A Tel Aviv Sourasky Medical Center Tel Aviv Israel
Department of Medicine Division of Hematology Karolinska Institutet Stockholm Sweden
Department of Medicine Division of Hematology University of Patras Medical School Patras Greece
Epidemiology and Cancer Statistics Group Department of Health Sciences University of York York UK
St James's Institute of Oncology Leeds Teaching Hospitals Leeds UK
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ClinicalTrials.gov
NCT00600860