Journal
LEUKEMIA & LYMPHOMA
Volume 60, Issue 13, Pages 3181-3187Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428194.2019.1622700
Keywords
MDS; HMA; transfusion; azacitdine; decitabine
Categories
Funding
- NCI's Cancer Clinical Investigator Team Leadership Award (CCITLA)
- National Cancer Institute of the National Institutes of Health [P30 CA016359]
- Dennis Cooper Hematology Young Investigator Award
- National Cancer Institute [P30 CA016359]
- California Department of Public Health as part of the statewide cancer reporting program [103885]
- National Cancer Institute (NCI)'s Surveillance, Epidemiology and End Results (SEER) Program [N01-PC-35136, N01-PC-35139, N02-PC-15105]
- Centers for Disease Control and Prevention's National Program of Cancer Registries [U55/CCR921930-02]
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Most patients with lower risk myelodysplastic syndromes (LR-MDS) become red blood cell (RBC) transfusion dependent at some time during their disease course. Hypomethylating agents (HMAs) are frequently used in this setting; however, reported rates of in RBC transfusion independence (TI) achieved with HMA therapy vary significantly between studies. Here we study the real-life clinical effectiveness of HMA in inducing RBC TI in anemic LR-MDS patients using the Surveillance, Epidemiology and End Results (SEER)-Medicare database. We find that approximately 40% of LR-MDS patients who were receiving RBC transfusions and 33% who were dependent on RBC transfusions at HMA initiation ultimately achieved TI. The receipt of >= 3 transfusions in the 8-week period before HMA initiation was significantly associated with lower odds of achieving TI. Our study provides important population level estimates of clinical effectiveness of HMAs in LR-MDS.
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