Division of Hematology/Medical Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Institute for Clinical Evaluative Sciences, Toronto, Canada.
Leuk Lymphoma. 2020 Jun;61(6):1445-1454. doi: 10.1080/10428194.2020.1723012. Epub 2020 Feb 8.
Despite the adoption of azacitidine (AZA) in higher-risk MDS/low-blast count AML, limited 'real-world' data on resource utilization and toxicity exist. We linked the Ontario AZA-MDS registry to population-based administrative databases. Among 877 patients in the registry, 705 (80.4%) had at least one emergency department (ED) visit, 290 (33.1%) had an ED visit during their first cycle and 680 patients (77.5%) had at least one hospitalization (mean length 17.7 days, 95% CI 16.3-19.1). Older age, rurality, non-response to AZA, transfusion dependence, IPSS score, and greater comorbidity were independent predictors of increased ED visits; while greater comorbidity, non-response to AZA, and transfusion dependence were associated with longer hospitalization. When restricted to receiving ≥3 cycles, hospitalization during the first cycle was associated with increased risk of death. Our analysis of 'real-world' patients treated with AZA demonstrates significant healthcare utilization and increased risk of death for patients hospitalized during their first cycle. These results will inform patients/providers about 'real-world' toxicities of AZA.
尽管在高风险 MDS/低细胞计数 AML 中采用了阿扎胞苷（AZA），但关于资源利用和毒性的“真实世界”数据有限。我们将安大略 AZA-MDS 注册处与基于人群的行政数据库相关联。在注册处的 877 名患者中，705 名（80.4%）至少有一次急诊就诊，290 名（33.1%）在第一个周期中有急诊就诊，680 名患者（77.5%）至少有一次住院治疗（平均住院时间为 17.7 天，95%CI 为 16.3-19.1）。年龄较大、农村地区、对 AZA 无反应、依赖输血、IPSS 评分较高和合并症较多是急诊就诊增加的独立预测因素；而合并症较多、对 AZA 无反应和依赖输血与住院时间延长有关。当限制为接受≥3 个周期时，第一个周期住院与死亡风险增加有关。我们对接受 AZA 治疗的“真实世界”患者的分析表明，第一个周期住院的患者有大量的医疗保健利用和死亡风险增加。这些结果将使患者/提供者了解 AZA 的“真实世界”毒性。
