Daily practice management of myelodysplastic syndromes in France: data from 907 patients in a one-week cross-sectional study by the Groupe Francophone des Myelodysplasies.
BACKGROUND
There is little published information on the everyday clinical management of myelodysplastic syndromes in real world practice.


METHODS
We conducted a cross-sectional study of all patients with myelodysplastic syndromes attending 74 French centers in a 1-week period for inpatient admission, day-hospital care or outpatient visits.


RESULTS
Nine hundred and seven patients were included; 67.3% had lower-risk myelodysplastic syndromes (International Prognostic Scoring System: low or intermediate-1). Karyotype had been analyzed in 82.5% of the cases and was more often of intermediate or poor risk in patients under 65 years old compared with those who were older. Red blood cell transfusions accounted for as many as 31.4% of the admissions. Endogenous erythropoietin level was less than 500 IU/L in 88% of the patients tested. Erythroid stimulating agents had been or were being used in 36.8% of the lower risk patients, iron chelation in 31% of lower risk patients requiring red blood cell transfusions and lenalidomide in 41% of lower risk patients with del 5q. High-dose chemotherapy, hypomethylating agents, low dose cytarabine and allogeneic stem cell transplantation had been or were being used in 14.8%, 31.1%, 8.8% and 5.1%, respectively, of higher-risk patients.


CONCLUSIONS
Karyotype is now assessed in most patients with myelodysplastic syndromes, and patients under 65 years old may have more aggressive disease. Apart from erythroid-stimulating agents and, in higher-risk myelodysplastic syndromes, hypomethylating agents, specific treatments are used in a minority of patients with myelodysplastic syndromes and red blood cell transfusions still represent the major reason for hospital admission.
Kelaidi
Charikleia
C
Groupe Francophone des Myélodysplasies, Hôpital Avicenne, Bobigny, France.
Stamatoullas
Aspasia
A
Beyne-Rauzy
Odile
O
Raffoux
Emmanuel
E
Quesnel
Bruno
B
Guerci
Agnes
A
Dreyfus
François
F
Brechignac
Sabine
S
Berthou
Christian
C
Prebet
Thomas
T
Hicheri
Yosr
Y
Hacini
Maya
M
Delaunay
Jacques
J
Gourin
Marie-Pierre
MP
Camo
Jean-Marie
JM
Zerazhi
Hacene
H
Taksin
Anne-Laure
AL
Legros
Laurence
L
Choufi
Bachra
B
Fenaux
Pierre
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D019468:Disease Management; D017707:Erythrocyte Transfusion / Q000639:trends; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005602:France / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000639:trends; D006801:Humans; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy*; D013997:Time Factors; D055815:Young Adult
D000970:Antineoplastic Agents; D004921:Erythropoietin