title: Early introduction of ESA in low risk MDS patients may delay the need for RBC transfusion: a retrospective analysis on 112 patients.
abstract: ESAs are increasingly used to treat anemia of lower risk MDS, even before RBC transfusion requirement. From a previously published patient cohort treated with ESAs, we selected 112 patients with de novo low or int-1 IPSS MDS with Hb<10 g/dl, serum EPO<500 UI/l and who had never been transfused. Erythroid response rate at 12 weeks was 63.1% (IWG 2006). In multivariate analysis, an interval between diagnosis and ESA onset<6 months, Hb level>9 g/dl, and serum EPO<100 UI/l predicted better response to ESA while shorter interval between diagnosis and ESA onset (p=0.01), lower serum EPO (p=0.04) and WHO diagnosis of RCMD-RS (p=0.03) were associated with longer response. Median interval from diagnosis to transfusion dependency was 80 months and 35 months, respectively, in patients with onset of ESA < 6 months and ≥ 6 months from diagnosis (p=0.007). Those results support early onset of ESA in lower risk MDS, to better avoid the consequences of anemia. Early introduction of ESA may also delay the need for RBC transfusions, hypothetically by slowing the disease course, but prospective studies are required to further assess this point.
authors.affiliation: Hôpital Cochin, APHP, Paris, France. sophie.park@cch.aphp.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Park
authors.forename: Charikleia
authors.initials: C
authors.lastname: Kelaidi
authors.forename: Rosa
authors.initials: R
authors.lastname: Sapena
authors.forename: Dominique
authors.initials: D
authors.lastname: Vassilieff
authors.forename: Odile
authors.initials: O
authors.lastname: Beyne-Rauzy
authors.forename: Valérie
authors.initials: V
authors.lastname: Coiteux
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
authors.forename: Christophe
authors.initials: C
authors.lastname: Ravoet
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cheze
authors.forename: Christian
authors.initials: C
authors.lastname: Rose
authors.forename: Laurence
authors.initials: L
authors.lastname: Legros
authors.forename: Aspasia
authors.initials: A
authors.lastname: Stamatoullas
authors.forename: Martine
authors.initials: M
authors.lastname: Escoffre-Barbe
authors.forename: Agnès
authors.initials: A
authors.lastname: Guerci
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Chaury
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: François
authors.initials: F
authors.lastname: Dreyfus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000517:prevention & control; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa; D017707:Erythrocyte Transfusion; D004921:Erythropoietin / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000628:therapy; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa