Transfusion independence in patients with myelodysplastic syndromes

Abstract

Anemia is the most common cytopenia associated with myelodysplastic syndromes (MDS). Current management relies on frequent red blood cell (RBC) transfusions and erythroid growth factors to alleviate symptoms. However, the dependence of patients with MDS on repeated RBC transfusions often results in significant clinical and economic consequences, poorer outcomes, and diminished health-related quality of life. In addition, the intensity and duration of RBC transfusion dependence can influence responses to treatment after disease progression.

Concepts and goals in the management of transfusional iron overload

“…Patients with myelodysplastic syndromes (MDS) may develop a long-term dependence on blood transfusions and require iron-chelation therapy [10,11]. Postmortem studies in the 1970s [12] and magnetic resonance imaging (MRI) data obtained more recently [13], show that after 75 or more units of transfused blood, over half of patients will have excess iron in the myocardium.…”

Improving accuracy of prognosis in patients with myelodysplastic syndromes using self-reported quality of life data. Opportunities for a new research agenda in developing prognostic models

“…In addition, there is evidence showing that physical, functional, emotional, and social well-being of MDS patients can be affected by disease-and treatmentrelated factors thereby substantially impacting quality of life (QoL) [3][4][5]. In these patients, QoL may be compromised for several reasons, including severe anemia, the frequent occurrence of infections, and the need of blood transfusions [6,7].…”

Myelodysplastic Syndromes: Aspects of Current Medical Care and Economic Considerations in Germany

“…It may be difficult to compare survival in patients with or without chelation therapy, since the relationship between iron overload, high ferritin, RBC transfusions, and shorter survival is not completely understood. Generally, it can be stated that long-term RBC transfusion has a negative effect on quality of life and survival in MDS patients [36].…”