Unit of Pharmacotherapy, Epidemiology and Economics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
Department of Clinical Pharmacy and Pharmacology and.
Blood Adv. 2021 Mar 9;5(5):1344-1351. doi: 10.1182/bloodadvances.2020003381.
Population-based studies that contain detailed clinical data on patients with myelodysplastic syndrome (MDS) are scarce. This study focused on the real-world overall survival (OS) of MDS patients in association with comorbidities, specifically malignancies. An observational population-based study using the HemoBase registry was performed, including all patients with MDS diagnosed between 2005 and 2017 in Friesland, a Dutch province. Detailed information about diagnosis, patient characteristics, previous treatment of malignancies, and comorbidities according to the Charlson Comorbidity Index (CCI) was collected from electronic health records. Patients were followed up until June 2019. Kaplan-Meier plots and Cox regression analyses were used to study survival differences. In the 291 patients diagnosed with MDS, the median OS was 25.3 months (95% confidence interval [CI], 20.3-30.2). OS was significantly better for patients with CCI score <4, age <65 years, female sex, and low-risk MDS. Fifty-seven patients (20%) had encountered a prior malignancy (excluding nonmelanoma skin cancer), and a majority (38 patients; 67%) were therapy related. Both therapy-related and secondary MDSs were associated with worse OS (hazard ratio, 1.51; 95% CI, 1.02-2.23 and 1.58; 95% CI, 0.95-2.65, respectively), as compared with de novo MDS patients (P = .04). Patients in remission at time of MDS diagnosis had a similar median OS compared with patients with de novo MDS (25.5 vs 28.3 months). This population-based study involving all newly diagnosed MDS patients over a 13-year period in Friesland showed that multiple comorbidities, including previous malignancies, are associated with shorter OS. OS was not related to the use of radiotherapy or chemotherapy.
基于人群的研究中包含了有关骨髓增生异常综合征（MDS）患者的详细临床数据，但此类研究非常匮乏。本研究主要关注与合并症（尤其是恶性肿瘤）相关的 MDS 患者的真实世界总生存期（OS）。本研究使用 HemoBase 登记处进行了一项观察性基于人群的研究，纳入了 2005 年至 2017 年间在荷兰弗里斯兰省被诊断为 MDS 的所有患者。从电子健康记录中收集了有关诊断、患者特征、恶性肿瘤的既往治疗和 Charlson 合并症指数（CCI）的详细信息。患者随访至 2019 年 6 月。采用 Kaplan-Meier 图和 Cox 回归分析来研究生存差异。在 291 例被诊断为 MDS 的患者中，中位 OS 为 25.3 个月（95%置信区间 [CI]，20.3-30.2）。CCI 评分<4、年龄<65 岁、女性和低危 MDS 患者的 OS 显著更好。57 例（20%）患者患有先前的恶性肿瘤（不包括非黑色素瘤皮肤癌），其中大多数（38 例；67%）与治疗相关。与初发 MDS 患者相比，治疗相关 MDS 和继发性 MDS 与更差的 OS 相关（危险比，1.51；95%CI，1.02-2.23 和 1.58；95%CI，0.95-2.65；P=0.04）。在 MDS 诊断时处于缓解期的患者的中位 OS 与初发 MDS 患者相似（25.5 与 28.3 个月）。这项涉及在弗里斯兰省 13 年内所有新诊断 MDS 患者的基于人群的研究表明，多种合并症，包括先前的恶性肿瘤，与较短的 OS 相关。OS 与放疗或化疗的使用无关。
