title: Transfusion dependence development and disease evolution in patients with MDS and del(5q) and without transfusion needs at diagnosis.
abstract: Patients with isolated del(5q) and MDS are considered to have good prognosis as compared to other MDS subtypes. Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide is the first choice treatment. However, there are no data regarding natural evolution of anemia in patients diagnosed in MDS and del(5q) without TD, factors that may impact on the development of TD or disease outcome. In the present study we have performed a retrospective multicenter analysis on 83 patients with low-int 1 MDS and del(5q) without TD. During the study 61 patients became TD at a median of 1.7 years and only the Hb level 9 g/dL was associated with poorer TFS (p = 0.007) in the multivariate analysis. Among these 61 TD patients, 49 received treatment (19 Lenalidomide). Median follow up was 48 months, estimated OS at 2 and 5 year was 92% and 50% respectively. In the multivariate analysis for OS, platelets <100,000 mm(-3) and Lenalidomide treatment retained the statistical significant impact. LFS at 2 and 5 years was 86% and 73% respectively, and median time to sAML was 8.16 years (CI 95%: 6.05-10.27). In the multivariate analysis only thrombocytopenia retained statistical significance. In summary, this retrospective study show that level of Hb is an important parameter in order to determine the time until TD, it should be also stressed the importance of an early treatment in order to prevent TD development and shorter survival.
authors: Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain.
authors: Silvia M
authors: SM
authors: Rojas
authors: Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain. Electronic address: mdiezcampelo@usal.es.
authors: María
authors: M
authors: Díez-Campelo
authors: Department of Hematology, Hospital central de Asturias, Oviedo, Spain.
authors: Elisa
authors: E
authors: Luño
authors: Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain.
authors: Mónica
authors: M
authors: Cabrero
authors: Department of Hematology, Hospital del Mar Hospital, Barcelona, Spain.
authors: Carme
authors: C
authors: Pedro
authors: Department of Hematology, Hospital Clínico de Valencia, Valencia, Spain.
authors: Marisa
authors: M
authors: Calabuig
authors: Department of Hematology, Hospital Clínico, Barcelona, Spain.
authors: Benet
authors: B
authors: Nomdedeu
authors: Department of Hematology, Hospital 12 de Octubre, Madrid, Spain.
authors: Teresa
authors: T
authors: Cedena
authors: Department of Hematology, Hospital Universitario de Cruces, Bilbao, Spain.
authors: Beatriz
authors: B
authors: Arrizabalaga
authors: Department of Hematology, Consorcio Sanitario de Terrasa, Barcelona, Spain.
authors: Marta
authors: M
authors: García
authors: Department of Hematology, Hospital Virgen de la Luz, Cuenca, Spain.
authors: Carlos
authors: C
authors: Cerveró
authors: Department of Hematology, Hospital General Universitario, Valencia, Spain.
authors: Rosa
authors: R
authors: Collado
authors: Department of Hematology, Hospital Universitario de Zaragoza, Zaragoza, Spain.
authors: Gemma
authors: G
authors: Azaceta
authors: Department of Hematology, Hospital de Txagorritxu, Vitoria-Gasteiz, Spain.
authors: M Teresa
authors: MT
authors: Ardanaz
authors: Department of Hematology, Hospital Universitario Puerta del Mar, Cadiz, Spain.
authors: Juan Antonio
authors: JA
authors: Muñoz
authors: Department of Hematology, Hospital Germans Trias i Pujol, Badalona, Spain.
authors: Blanca
authors: B
authors: Xicoy
authors: Department of Hematology, Hospital Severo Ochoa, Madrid, Spain.
authors: M José Requena
authors: MJ
authors: Rodríguez
authors: Department of Hematology, Hospital Son Llátzer, Palma de Mallorca, Spain.
authors: Joan
authors: J
authors: Bargay
authors: Department of Hematology, Hospital Sagunto, Sagunto, Spain.
authors: M Jesús Arilla
authors: MJ
authors: Morell
authors: Department of Hematology, Hospital de Povisa, Vigo, Spain.
authors: Adriana
authors: A
authors: Simiele
authors: Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain.
authors: Consuelo
authors: C
authors: del Cañizo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D018450:Disease Progression; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D013792:Thalidomide; D000077269:Lenalidomide
keywords: Hb level; Myelodysplastic syndrome; Survival; Transfusion dependence; del(5q)