The MDS Beacon™

Researchers from Italy confirmed that severe anemia has a negative impact on survival of patients with myelodysplastic syndromes (MDS). The severity of anemia is therefore a good prognostic tool to evaluate MDS progression and overall survival. These results were presented at the 2010 European Hematology Association (EHA) Congress in Barcelona, Spain, last month.

Anemia, or low red blood cell counts, is a very common side effect of MDS. Over 90 percent of patients are anemic at the time of their MDS diagnoses. About 50 percent of MDS patients experience moderate to severe anemia (see related Beacon article for more information on anemia in MDS).

Some anemic MDS patients require regular red blood cell transfusions to keep the number of blood cells at normal levels. The need for regular red blood cell transfusions is linked to increased heart failure risk and decreased overall survival.

The Italian researchers worked to identify how much of an impact the degree of anemia has on the prognosis of MDS patients. They divided 920 MDS patients into different categories based on their levels of red blood cells and monitored decreases in hemoglobin (the oxygen-carrying molecule in red blood cells) levels.

The red blood cell level categories were analyzed in conjunction with the patients’ age, World Health Organization subgroups of MDS, International Prognostic Scoring System criteria for cytogenetics (chromosome changes), blood cell counts, and the presence of heart-related diseases. Separate analyses for male and female patients were performed.

The researchers found that decreasing red blood cell counts were associated with a progressive worsening of overall survival. Results showed that males with less than 9 g hemoglobin/dL and females with less than 8 g hemoglobin/dL had significantly poorer overall survival than patients with higher hemoglobin levels. These hemoglobin thresholds were also linked to a significantly higher risk of heart-related death.

The researchers concluded that gender-specific hemoglobin levels are more objective prognostic tools than previously used methods of measuring transfusion dependence. The degree of anemia was also shown to more closely predict patient prognosis, such as overall survival and risk of MDS progression to leukemia.

For more information, please see abstract 0310 at the EHA meeting website.