The MDS Beacon™

Researchers from the University of Pittsburgh Medical Center published study results in Transfusion indicating that certain myelodysplastic syndromes (MDS) patients who require repeated red blood cell transfusions may benefit from a treatment called iron chelation therapy (ICT).

ICT is used to remove excess iron that accumulates in the blood with multiple transfusions. Patients treated with ICT in this study had a median survival time of 9 years compared to 5 years for untreated patients.

The results in the study are based on an analysis of past medical records from MDS patients or patients with severe anemia. The mean age of patients at the time of diagnosis was 71 years. Researchers evaluated each patient to see if he or she was eligible for ICT.

ICT-eligibility was defined as at least 20 units of red blood cell transfusions or if iron-levels exceeded a certain amount. Medical records from ICT-eligible patients were then reviewed to evaluate whether ICT treatment had an effect on patient survival.

Among 128 ICT-eligible patients (low- and high-risk MDS and severe anemia), 54 were treated with the therapy and had a median survival of 9 years from when they became eligible for the treatment. Seventy four patients were untreated and had a median survival of 5 years.

Out of the 128 ICT-eligible patients, 78 patients had low-risk MDS. Focusing on these low-risk MDS patients, 41 percent were treated with the therapy and 59 percent received no treatment. Although results indicated longer overall survival with ICT treatment, the difference between the survival times of the two groups was not statistically significant. Researchers indicated that this should be reevaluated with a larger patient group.

Outside experts have discussed the studies’ results and the potential of ICT for MDS patients. A. Tefferi of the Mayo Clinic and R. M. Stone of the Dana-Farber Cancer Institute at Harvard Medical School published an editorial in the August issue of Leukemia. In this article they discuss that complications from excess iron in the body do not occur until several years after the organs are exposed to iron. Thus, they question the clinical value of ICT in MDS patients in the critical years following MDS diagnosis.

The University of Pittsburgh researchers discussed that the study may be biased due to lack of controls, and they recommend that reviewers interpret with caution. They suggest that more patients who are eligible for ICT receive the therapy and encourage a future large-scale, randomized study.

For more information on the University of Pittsburgh study, please see the summary in Transfusion (abstract). To read the editorial, please see the online version of Leukemia.