The MDS Beacon™

Myelodysplastic syndromes (MDS)-related complications and progression to acute myelogenous leukemia (AML) are the leading cause of death for low- and intermediate-1 risk MDS patients, according to a report published in the journal Cancer.  The most common complications include infection and bleeding.

In their study, the researchers sought to discover the cause of death in low-risk MDS patients where the disease had not progressed to AML in an attempt to guide early therapy decisions.

Currently, the exact cause of death in the lower risk MDS population is not well understood. Low- and intermediate-1 risk MDS patients are typically only given supportive care, such as transfusions and growth factors, without therapeutic treatment.  They receive disease-slowing agents only if their disease shows signs of progressing, such as higher blast percentages in the bone marrow, increasingly low blood counts, or transfusion dependence.

“A large group of patients with lower risk disease are not offered therapy mainly because physicians believe that this is a benign condition,” said Dr. Guillermo Garcia-Manero, a study author. “We make the point of the need to develop targeted interventions for patients with low- and intermediate-1 MDS.”

The researchers analyzed the reported causes of death for 273 low- and intermediate-1 risk MDS patients who had been referred to the M.D. Anderson Cancer Center in Texas between 1980 and 2004.  The patients’ median age was 66 years.

Infection, bleeding, transformation to AML, and disease progression were defined as MDS-related causes of death. All other deaths were classified as non-MDS related.

Researchers found that 84 percent of patients died from MDS-related complications, rather than age-related reasons.

The most common MDS-related causes of deaths were infection (38 percent), bleeding (13 percent), and transformation to AML (15 percent).  Bleeding occurred mostly in the gastrointestinal tract, lungs, and central nervous system. The most common non-MDS-related cause of death was cardiovascular complications.

The median overall survival of the group was 59 weeks from the time of referral to the cancer center.

The researchers concluded that although the results needed to be validated with different low-risk MDS populations, improved patient survival could be accomplished through early therapeutic intervention.

They suggested low doses of agents such as Vidaza (azacitidine) and Dacogen (decitabine), combinations of Revlimid (lenalidomide) with growth factors, and other new treatment combinations may be potential treatment options for low-risk MDS patients.

For more information, please see the study in the journal Cancer (abstract).