Article (Scientific journals)
Adequate iron chelation therapy for at least six months improves survival in transfusion-dependent patients wih lower risk myelodysplastic syndromes
Delforge, Michel; Selleslag, Dominik; BEGUIN, Yves et al.
2014In Leukemia Research, 38, p. 557-563
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Keywords :
myelodysplastic syndromes
Abstract :
[en] Background: Most patients with myelodysplastic syndromes (MDS) require transfusions at the risk of ironoverload and associated organ damage, and death. Emerging evidence indicates that iron chelation ther-apy (ICT) could reduce mortality and improve survival in transfusion-dependent MDS patients, especiallythose classified as International Prognostic Scoring System (IPSS) Low or Intermediate-1 (Low/Int-1).Methods: Follow-up of a retrospective study. Sample included 127 Low/Int-1 MDS patients from 28 centersin Belgium. Statistical analysis stratified by duration (≥6 versus <6 months) and quality of chelation (adequate versus weak). Results: Crude chelation rate was 63% but 88% among patients with serum ferritin ≥1000 g/L. Of the 80chelated patients, 70% were chelated adequately mainly with deferasirox (26%) or deferasirox followingdeferoxamine (39%). Mortality was 70% among non-chelated, 40% among chelated, 32% among patientschelated ≥6 m, and 30% among patients chelated adequately; with a trend toward reduced cardiacmortality in chelated patients. Overall, median overall survival (OS) was 10.2 years for chelated and 3.1years for non-chelated patients (p < 0.001). For patients chelated ≥6 m or patients classified as adequatelychelated, median OS was 10.5 years. Mortality increased as a function of average monthly transfusionintensity (HR = 1.08, p = 0.04) but was lower in patients receiving adequate chelation or chelation ≥6 m(HR = 0.24, p < 0.001). Conclusion: Six or more months of adequate ICT is associated with markedly better overall survival. Thissuggests a possible survival benefit of ICT in transfusion-dependent patients with lower-risk MDS.
Disciplines :
Hematology
Author, co-author :
Delforge, Michel
Selleslag, Dominik
BEGUIN, Yves  ;  Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Triffet, Agnès
Mineur, Philippe
Theunissen, Koen
Graux, Carlos
Trullemans, Fabienne
Boulet, Dominique
Van Eygen, Koen
Noens, Lucien
Van Steenweghen, Steven
Lemmens, Jan
Pierre, Pascal
D'Hondt, Randal
Ferrant, Augustin
Deeren, Dries
Van de Velde, Ann
Wynendaeke, Wim
André, Marc
De Bock, Robrecht
Efira, André
Breems, Dimitri
Deweweire, Anne
Geldhof, Kurt
Pluymers, Wim
Harrington, Amanda
MacDonald, Karen
Abraham, Ivo
Ravoet, Christophe
More authors (20 more) Less
Language :
English
Title :
Adequate iron chelation therapy for at least six months improves survival in transfusion-dependent patients wih lower risk myelodysplastic syndromes
Publication date :
2014
Journal title :
Leukemia Research
ISSN :
0145-2126
Publisher :
Pergamon Press - An Imprint of Elsevier Science
Volume :
38
Pages :
557-563
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 15 May 2014

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