Haematologica (Mar 2020)
Impact of red blood cell transfusion dose density on progression-free survival in patients with lower-risk myelodysplastic syndromes
- Louise de Swart,
- Simon Crouch,
- Marlijn Hoeks,
- Alex Smith,
- Saskia Langemeijer,
- Pierre Fenaux,
- Argiris Symeonidis,
- Jaroslav Cermâk,
- Eva Hellström-Lindberg,
- Reinhard Stauder,
- Guillermo Sanz,
- Moshe Mittelman,
- Mette Skov Holm,
- Luca Malcovati,
- Krzysztof Mądry,
- Ulrich Germing,
- Aurelia Tatic,
- Aleksandar Savic,
- Antonio Medina Almeida,
- Njetocka Gredelj-Simec,
- Agnes Guerci-Bresler,
- Odile Beyne-Rauzy,
- Dominic Culligan,
- Ioannis Kotsianidis,
- Raphael Itzykson,
- Corine van Marrewijk,
- Nicole Blijlevens,
- David Bowen,
- Theo de Witte,
- on behalf of the EUMDS Registry Participants
Affiliations
- Louise de Swart
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
- Simon Crouch
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
- Marlijn Hoeks
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands;Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands
- Alex Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
- Saskia Langemeijer
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
- Pierre Fenaux
- Service d’Hématologie, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris and Université Paris 7, Paris, France
- Argiris Symeonidis
- Department of Medicine, Division of Hematology, University of Patras Medical School, Patras, Greece
- Jaroslav Cermâk
- Department of Clinical Hematology, Institute of Hematology & Blood Transfusion, Praha, Czech Republic
- Eva Hellström-Lindberg
- Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden
- Reinhard Stauder
- Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
- Guillermo Sanz
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Moshe Mittelman
- Department of Medicine A, Tel Aviv Sourasky (Ichilov) Medical Center and Sackler Medical Faculty, Tel Aviv University, Tel Aviv, Israel
- Mette Skov Holm
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
- Luca Malcovati
- Department of Hematology Oncology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
- Krzysztof Mądry
- Department of Hematology, Oncology and Internal Medicine, Warsaw Medical University, Warsaw, Poland
- Ulrich Germing
- Department of Hematology, Oncology and Clinical Immunology, Universitatsklinik Düsseldorf, Düsseldorf, Germany
- Aurelia Tatic
- Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
- Aleksandar Savic
- Clinic of Hematology - Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Antonio Medina Almeida
- Department of Clinical Hematology, Hospital da Luz, Lisbon, Portugal
- Njetocka Gredelj-Simec
- Department of Internal Medicine, Division of Hematology, Merkur University Hospital, Zagreb, Croatia
- Agnes Guerci-Bresler
- Service d’Hématologie, Centre Hospitalier Universitaire (CHU) Brabois Vandoeuvre, Nancy, France
- Odile Beyne-Rauzy
- Service de Médecine Interne, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- Dominic Culligan
- Department of Haematology, Aberdeen Royal Infirmary, Aberdeen, UK
- Ioannis Kotsianidis
- Department of Hematology, Democritus University of Thrace Medical School, University Hospital of Alexandroupolis, Alexandroupolis, Greece
- Raphael Itzykson
- Service d’Hématologie, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris and Université Paris 7, Paris, France
- Corine van Marrewijk
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
- Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
- David Bowen
- St. James’s Institute of Oncology, Leeds Teaching Hospitals, Leeds, UK
- Theo de Witte
- Department of Tumor Immunology - Nijmegen Center for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- on behalf of the EUMDS Registry Participants
- DOI
- https://doi.org/10.3324/haematol.2018.212217
- Journal volume & issue
-
Vol. 105,
no. 3
Abstract
Progression-free survival (PFS) of patients with lower-risk myelodysplastic 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 proportional 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 (P
