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Overall survival, MDS subtypes


  • There is little information on which MDS subtypes might benefit more from ICT.
  • In one analysis, patients with lower IPSS risk MDS receiving ICT had significantly superior OS in the subtypes RA and RARS/RARS-t, but not in RCMD/RCMD-RS, RAEB1, MDSU&MDS/ MPNU, or del(5q)MDS, though this study was limited by small sample sizes in the latter groups.
  • Although there was no difference in OS between ICT & non-ICT patients with RCMD/ RCMD-RS, clear HI-E occurred in 3 ICT patients in this group with a >50% reduction in RBC transfusion requirements in 2 patients & long term transfusion independence resulting in significantly improved QOL in a 3rd.
Charts - Overall survival, MDS subtypes

Figure. Overall survival in patients with lower IPSS risk MDS receiving red blood cell transfusions by receipt of ICT a) all transfused patients b) RA c) RARS/RARS-t d) RCMD/RCMD-RS


del(5q) MDS, MDS with deletion of chromosome 5q as the sole cytogenetic abnormality; ICT, iron chelation therapy; EB, excess blasts; HI-E, hematologic improvement erythroid; IPSS, International Prognostic Scoring System; MDS, myelodysplastic syndromes; MPN, myeloproliferative neoplasm; OS, overall survival; QOL, quality of life; RA, refractory anemia; RCMD, refractory cytopenia with multilineage dysplasia; RBC, red blood cell; RS, ringed sideroblasts; t, treatment related; U, unclassified. Wong SA, Leitch HA. Leuk Res. 2018 Jan;64:24-29.