Transfusion dependence development and disease evolution in patients with MDS and del(5q) and without transfusion needs at diagnosis
Abstract Patients with isolated del(5q) and MDS are considered to have good prognosis as compared to other MDS subtypes. Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide...
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| Veröffentlicht in: | Leukemia research 2014-03, Vol.38 (3), p.304-309 |
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| creator | Rojas, Silvia M Díez-Campelo, María Luño, Elisa Cabrero, Mónica Pedro, Carme Calabuig, Marisa Nomdedeu, Benet Cedena, Teresa Arrizabalaga, Beatriz García, Marta Cerveró, Carlos Collado, Rosa Azaceta, Gemma Ardanaz, Mª Teresa Muñoz, Juan Antonio Xicoy, Blanca Rodríguez, Mª José Requena Bargay, Joan Morell, Mª Jesús Arilla Simiele, Adriana del Cañizo, Consuelo |
| description | Abstract Patients with isolated del(5q) and MDS are considered to have good prognosis as compared to other MDS subtypes. Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide is the first choice treatment. However, there are no data regarding natural evolution of anemia in patients diagnosed in MDS and del(5q) without TD, factors that may impact on the development of TD or disease outcome. In the present study we have performed a retrospective multicenter analysis on 83 patients with low-int 1 MDS and del(5q) without TD. During the study 61 patients became TD at a median of 1.7 years and only the Hb level 9 g/dL was associated with poorer TFS ( p = 0.007) in the multivariate analysis. Among these 61 TD patients, 49 received treatment (19 Lenalidomide). Median follow up was 48 months, estimated OS at 2 and 5 year was 92% and 50% respectively. In the multivariate analysis for OS, platelets |
| doi_str_mv | 10.1016/j.leukres.2013.11.005 |
| format | Article |
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Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide is the first choice treatment. However, there are no data regarding natural evolution of anemia in patients diagnosed in MDS and del(5q) without TD, factors that may impact on the development of TD or disease outcome. In the present study we have performed a retrospective multicenter analysis on 83 patients with low-int 1 MDS and del(5q) without TD. During the study 61 patients became TD at a median of 1.7 years and only the Hb level 9 g/dL was associated with poorer TFS ( p = 0.007) in the multivariate analysis. Among these 61 TD patients, 49 received treatment (19 Lenalidomide). Median follow up was 48 months, estimated OS at 2 and 5 year was 92% and 50% respectively. In the multivariate analysis for OS, platelets <100,000 mm−3 and Lenalidomide treatment retained the statistical significant impact. LFS at 2 and 5 years was 86% and 73% respectively, and median time to sAML was 8.16 years (CI 95%: 6.05–10.27). In the multivariate analysis only thrombocytopenia retained statistical significance. In summary, this retrospective study show that level of Hb is an important parameter in order to determine the time until TD, it should be also stressed the importance of an early treatment in order to prevent TD development and shorter survival.</description><identifier>ISSN: 0145-2126</identifier><identifier>EISSN: 1873-5835</identifier><identifier>DOI: 10.1016/j.leukres.2013.11.005</identifier><identifier>PMID: 24333115</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anemia - diagnosis ; Anemia - etiology ; Anemia - mortality ; Anemia - therapy ; Antineoplastic Agents - therapeutic use ; Biomarkers, Tumor - analysis ; Blood Transfusion - statistics & numerical data ; Chromosome Deletion ; Chromosomes, Human, Pair 5 ; del(5q) ; Disease Progression ; Female ; Hb level ; Hematology, Oncology and Palliative Medicine ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myelodysplastic syndrome ; Myelodysplastic Syndromes - complications ; Myelodysplastic Syndromes - diagnosis ; Myelodysplastic Syndromes - drug therapy ; Myelodysplastic Syndromes - mortality ; Prognosis ; Retrospective Studies ; Survival ; Survival Analysis ; Thalidomide - analogs & derivatives ; Thalidomide - therapeutic use ; Time Factors ; Transfusion dependence</subject><ispartof>Leukemia research, 2014-03, Vol.38 (3), p.304-309</ispartof><rights>Elsevier Ltd</rights><rights>2013 Elsevier Ltd</rights><rights>Copyright © 2013 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-c52e908a7b31796526511fc1dae4fb0b5de95401bd7ea8fc668a9f9e6dba49253</citedby><cites>FETCH-LOGICAL-c453t-c52e908a7b31796526511fc1dae4fb0b5de95401bd7ea8fc668a9f9e6dba49253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.leukres.2013.11.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24333115$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rojas, Silvia M</creatorcontrib><creatorcontrib>Díez-Campelo, María</creatorcontrib><creatorcontrib>Luño, Elisa</creatorcontrib><creatorcontrib>Cabrero, Mónica</creatorcontrib><creatorcontrib>Pedro, Carme</creatorcontrib><creatorcontrib>Calabuig, Marisa</creatorcontrib><creatorcontrib>Nomdedeu, Benet</creatorcontrib><creatorcontrib>Cedena, Teresa</creatorcontrib><creatorcontrib>Arrizabalaga, Beatriz</creatorcontrib><creatorcontrib>García, Marta</creatorcontrib><creatorcontrib>Cerveró, Carlos</creatorcontrib><creatorcontrib>Collado, Rosa</creatorcontrib><creatorcontrib>Azaceta, Gemma</creatorcontrib><creatorcontrib>Ardanaz, Mª Teresa</creatorcontrib><creatorcontrib>Muñoz, Juan Antonio</creatorcontrib><creatorcontrib>Xicoy, Blanca</creatorcontrib><creatorcontrib>Rodríguez, Mª José Requena</creatorcontrib><creatorcontrib>Bargay, Joan</creatorcontrib><creatorcontrib>Morell, Mª Jesús Arilla</creatorcontrib><creatorcontrib>Simiele, Adriana</creatorcontrib><creatorcontrib>del Cañizo, Consuelo</creatorcontrib><title>Transfusion dependence development and disease evolution in patients with MDS and del(5q) and without transfusion needs at diagnosis</title><title>Leukemia research</title><addtitle>Leuk Res</addtitle><description>Abstract Patients with isolated del(5q) and MDS are considered to have good prognosis as compared to other MDS subtypes. Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide is the first choice treatment. However, there are no data regarding natural evolution of anemia in patients diagnosed in MDS and del(5q) without TD, factors that may impact on the development of TD or disease outcome. In the present study we have performed a retrospective multicenter analysis on 83 patients with low-int 1 MDS and del(5q) without TD. During the study 61 patients became TD at a median of 1.7 years and only the Hb level 9 g/dL was associated with poorer TFS ( p = 0.007) in the multivariate analysis. Among these 61 TD patients, 49 received treatment (19 Lenalidomide). Median follow up was 48 months, estimated OS at 2 and 5 year was 92% and 50% respectively. In the multivariate analysis for OS, platelets <100,000 mm−3 and Lenalidomide treatment retained the statistical significant impact. LFS at 2 and 5 years was 86% and 73% respectively, and median time to sAML was 8.16 years (CI 95%: 6.05–10.27). In the multivariate analysis only thrombocytopenia retained statistical significance. In summary, this retrospective study show that level of Hb is an important parameter in order to determine the time until TD, it should be also stressed the importance of an early treatment in order to prevent TD development and shorter survival.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia - diagnosis</subject><subject>Anemia - etiology</subject><subject>Anemia - mortality</subject><subject>Anemia - therapy</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biomarkers, Tumor - analysis</subject><subject>Blood Transfusion - statistics & numerical data</subject><subject>Chromosome Deletion</subject><subject>Chromosomes, Human, Pair 5</subject><subject>del(5q)</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Hb level</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myelodysplastic syndrome</subject><subject>Myelodysplastic Syndromes - complications</subject><subject>Myelodysplastic Syndromes - diagnosis</subject><subject>Myelodysplastic Syndromes - drug therapy</subject><subject>Myelodysplastic Syndromes - mortality</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Thalidomide - analogs & derivatives</subject><subject>Thalidomide - therapeutic use</subject><subject>Time Factors</subject><subject>Transfusion dependence</subject><issn>0145-2126</issn><issn>1873-5835</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkk1v1DAQhi0EokvhJ4ByLIcETxwn8QVUlU-piEPL2XLsCXibtVPbWdQ7PxyHXRDiAieP5GfekeYZQp4CrYBC-2JbTbjcBIxVTYFVABWl_B7ZQN-xkveM3ycbCg0va6jbE_Ioxi3NhADxkJzUDWMMgG_I9-ugXByXaL0rDM7oDDqNudzj5OcdulQoZwpjI6qIBe79tKQVtq6YVbIZiMU3m74WH19fHVCczvjt85_1-uGXVKQ_pjhEEwuVcqb64ny08TF5MKop4pPje0o-v31zffG-vPz07sPF-WWpG85SqXmNgvaqGxh0ouV1ywFGDUZhMw504AYFbygMpkPVj7pteyVGga0ZVCNqzk7J2SF3Dv52wZjkzkaN06Qc-iVK4NB2vOtB_AdKoWddCyyj_IDq4GMMOMo52J0KdxKoXF3JrTy6kqsrCSCzidz37DhiGXZofnf9kpOBVwcA8072FoOM2q52jA2okzTe_nPEy78S9GSd1Wq6wTuMW78ElxcuQcZaUnm1Hsx6L8AoZYJ17AeZfb7O</recordid><startdate>20140301</startdate><enddate>20140301</enddate><creator>Rojas, Silvia M</creator><creator>Díez-Campelo, María</creator><creator>Luño, Elisa</creator><creator>Cabrero, Mónica</creator><creator>Pedro, Carme</creator><creator>Calabuig, Marisa</creator><creator>Nomdedeu, Benet</creator><creator>Cedena, Teresa</creator><creator>Arrizabalaga, Beatriz</creator><creator>García, Marta</creator><creator>Cerveró, Carlos</creator><creator>Collado, Rosa</creator><creator>Azaceta, Gemma</creator><creator>Ardanaz, Mª Teresa</creator><creator>Muñoz, Juan Antonio</creator><creator>Xicoy, Blanca</creator><creator>Rodríguez, Mª José Requena</creator><creator>Bargay, Joan</creator><creator>Morell, Mª Jesús Arilla</creator><creator>Simiele, Adriana</creator><creator>del Cañizo, Consuelo</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20140301</creationdate><title>Transfusion dependence development and disease evolution in patients with MDS and del(5q) and without transfusion needs at diagnosis</title><author>Rojas, Silvia M ; 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Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide is the first choice treatment. However, there are no data regarding natural evolution of anemia in patients diagnosed in MDS and del(5q) without TD, factors that may impact on the development of TD or disease outcome. In the present study we have performed a retrospective multicenter analysis on 83 patients with low-int 1 MDS and del(5q) without TD. During the study 61 patients became TD at a median of 1.7 years and only the Hb level 9 g/dL was associated with poorer TFS ( p = 0.007) in the multivariate analysis. Among these 61 TD patients, 49 received treatment (19 Lenalidomide). Median follow up was 48 months, estimated OS at 2 and 5 year was 92% and 50% respectively. In the multivariate analysis for OS, platelets <100,000 mm−3 and Lenalidomide treatment retained the statistical significant impact. LFS at 2 and 5 years was 86% and 73% respectively, and median time to sAML was 8.16 years (CI 95%: 6.05–10.27). In the multivariate analysis only thrombocytopenia retained statistical significance. In summary, this retrospective study show that level of Hb is an important parameter in order to determine the time until TD, it should be also stressed the importance of an early treatment in order to prevent TD development and shorter survival.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>24333115</pmid><doi>10.1016/j.leukres.2013.11.005</doi><tpages>6</tpages></addata></record> |
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| ispartof | Leukemia research, 2014-03, Vol.38 (3), p.304-309 |
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| subjects | Adult Aged Aged, 80 and over Anemia - diagnosis Anemia - etiology Anemia - mortality Anemia - therapy Antineoplastic Agents - therapeutic use Biomarkers, Tumor - analysis Blood Transfusion - statistics & numerical data Chromosome Deletion Chromosomes, Human, Pair 5 del(5q) Disease Progression Female Hb level Hematology, Oncology and Palliative Medicine Humans Male Middle Aged Multivariate Analysis Myelodysplastic syndrome Myelodysplastic Syndromes - complications Myelodysplastic Syndromes - diagnosis Myelodysplastic Syndromes - drug therapy Myelodysplastic Syndromes - mortality Prognosis Retrospective Studies Survival Survival Analysis Thalidomide - analogs & derivatives Thalidomide - therapeutic use Time Factors Transfusion dependence |
| title | Transfusion dependence development and disease evolution in patients with MDS and del(5q) and without transfusion needs at diagnosis |
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