The long term risk of myelodysplastic syndromes among anemia patients: A population-based study

Medical Conditions and Modifiable Risk Factors for Myelodysplastic Syndrome: A Systematic Review

“…Nine of the articles were case-control studies (17,(27)(28)(29)(30)(31)(32)(33)(34). The remaining four articles were cohort studies (35)(36)(37)(38). The studies were conducted in the United States (n ¼ 6), China (n ¼ 4), Japan (n ¼ 1), Israel (n ¼ 1), and Sweden (n ¼ 1).…”

“…The two studies included in this systematic review that evaluated the association between history of anemia and MDS risk both used administrative data, and may lack access to key information necessary for full interpretation of the findings. In the study by Meytes and colleagues (37), all participants had low hemoglobin levels ( 12 g/dL), and there was no control group without anemia. The underlying cause of anemia was not evaluated.…”

“…In a casecontrol study using the SEER-Medicare database (6,067 MDS cases, 100,000 controls), Murphy and colleagues (34) found that elderly individuals with pernicious anemia (vitamin B 12 deficiency anemia) in the previous year were at higher odds of developing MDS (OR: 2.87; 95% CI: 2.53-3.26). Similarly, a cohort study in Israel found that among 116,517 adults with anemia, those with the lowest levels of hemoglobin (<9 g/dL) had the highest risk of developing MDS (n ¼ 418 MDS cases, HR: 5.09; 95% CI: 2.99-8.67) compared with individuals with hemoglobin levels between 11 and 12 g/dL (37). A previous history of diabetes mellitus (type of diabetes not specified) was associated with a higher risk of MDS (n ¼ 55 cases, HR: 1.57; 95% CI: 1.16-2.11), whereas a previous history of cardiovascular disease was associated with a lower risk of MDS (n ¼ 17 cases, HR: 0.39; 95% CI: 0.26-0.57).…”

“…Two articles received scores of 10 (17, 31). The other four articles received scores of 12 (37) or 13 (30,34,38). There were several reasons that papers did not achieve full points.…”

“…There were several reasons that papers did not achieve full points. Reasons for lower quality ratings included: (i) did not clearly state how MDS was identified and classified in their study population (17,31), (ii) did not include participants representative of the general population from which they were selected (17,31), (iii) did not recruit participants or cases/controls over the same period of time (31), (iv) presented analyses that were not planned a priori (34,37), (v) time period between exposure and outcome was not the same for cases and controls (31), (vi) did not adequately adjust for confounding (17,37), or (vii) did not account for the strengths or limitations of the study design when drawing conclusions (17,38 Smoking was also found to be associated higher risk of MDS in the case-control studies. Bj€ ork and colleagues (31) report slightly higher odds of MDS per pack-year of smoking among current smokers (OR: 1.013; 95% CI: 1.001-1.03), and a marginally statistically significantly higher odds among recent smokers (OR: 1.8; 95% CI: 1.0-3.3) compared with never smokers in a small case-control study with 75 MDS cases and 278 population-and hospital-based controls.…”