Impact of treatment with iron chelation therapy in patients with lower-risk myelodysplastic syndromes participating in the European MDS registry

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Marlijn Hoeks, Sanquin Blood Supply Foundation, Leiden University
  • ,
  • Ge Yu, University of York
  • ,
  • Saskia Langemeijer, Radboud University Nijmegen Medical Centre
  • ,
  • Simon Crouch, University of York
  • ,
  • Louise de Swart, Radboud University Nijmegen Medical Centre
  • ,
  • Pierre Fenaux, Hôpital Saint-Louis
  • ,
  • Argiris Symeonidis, University of Patras
  • ,
  • Jaroslav Čermák, Institute of Hematology and Blood Transfusion
  • ,
  • Eva Hellström-Lindberg, Karolinska Institutet
  • ,
  • Guillermo Sanz, Hospital la Fe
  • ,
  • Reinhard Stauder, Innsbruck Medical University
  • ,
  • Mette Skov Holm
  • Moshe Mittelman, Tel Aviv University
  • ,
  • Krzysztof Mądry, Medical University of Warsaw
  • ,
  • Luca Malcovati, Università Degli Studi di Pavia
  • ,
  • Aurelia Tatic, Fundeni Clinical Institute
  • ,
  • Antonio Medina Almeida, Hospital da Luz
  • ,
  • Ulrich Germing, Heinrich Heine University Düsseldorf
  • ,
  • Aleksandar Savic, University of Novi Sad
  • ,
  • Njetočka Gredelj Šimec, University of Zagreb
  • ,
  • Dominic Culligan, Aberdeen Royal Infirmary
  • ,
  • Raphael Itzykson, Hôpital Saint-Louis
  • ,
  • Agnes Guerci-Bresler, CHU Nancy Brabois
  • ,
  • Borhane Slama, Centre Hospitalier d'Avignon
  • ,
  • Arjan van de Loosdrecht, VU University Medical Center
  • ,
  • Corine van Marrewijk, Radboud University Nijmegen Medical Centre
  • ,
  • Jackie Droste, Radboud University Nijmegen Medical Centre
  • ,
  • Nicole Blijlevens, Radboud University Nijmegen Medical Centre
  • ,
  • Marian van Kraaij, Sanquin Blood Supply Foundation
  • ,
  • David Bowen, Leeds Teaching Hospitals NHS Trust
  • ,
  • Theo de Witte, Radboud University Medical Center
  • ,
  • Alex Smith, University of York

Iron overload due to red blood cell (RBC) transfusions is associated with morbidity and mortality in lower-risk myelodysplastic syndrome (MDS) patients. Many studies have suggested improved survival after iron chelation therapy (ICT), but valid data are limited. The aim of this study was to assess the effect of ICT on overall survival and hematologic improvement in lower-risk MDS patients in the European MDS registry. We compared chelated patients with a contemporary, non-chelated control group within the European MDS registry, that met the eligibility criteria for starting iron chelation. A Cox proportional hazards model was used to assess overall survival (OS), treating receipt of chelation as a time-varying variable. Additionally, chelated and non-chelated patients were compared using a propensity-score matched model. Of 2,200 patients, 224 received iron chelation. The hazard ratio and 95% confidence interval for OS for chelated patients, adjusted for age, sex, comorbidity, performance status, cumulative RBC transfusions, Revised-International Prognostic Scoring System (IPSS-R), and presence of ringed sideroblasts was 0.50 (0.34-0.74). The propensity-score analysis, matched for age, sex, country, RBC transfusion intensity, ferritin level, comorbidity, performance status, and IPSS-R, and, in addition, corrected for cumulative RBC transfusions and presence of ringed sideroblasts, demonstrated a significantly improved OS for chelated patients with a hazard ratio of 0.42 (0.27-0.63) compared to non-chelated patients. Up to 39% of chelated patients reached an erythroid response. In conclusion, our results suggest that iron chelation may improve OS and hematopoiesis in transfused lower-risk MDS patients. This trial was registered at clinicaltrials.gov identifier: 00600860.

OriginalsprogEngelsk
TidsskriftHaematologica
Vol/bind105
Nummer3
Sider (fra-til)640-651
Antal sider12
ISSN0390-6078
DOI
StatusUdgivet - 2020

Se relationer på Aarhus Universitet Citationsformater

ID: 181943930