Haring Yael, Goldschmidt Noa, Taha Shaimaa, Stemer Galia, Filanovsky Kalman, Hellman Ilana, Okasha Doaa, Krayem Baher, Levi Itai, Rosenbaum Hanna, Koren-Michowitz Maya, Yagna Shai, Nemets Anatoly, Gino-Moor Sharon, Saban Revital, Cohen Joseph, Halperin Erez, Wolach Ofir, Dally Najib, Merkel Drorit, Oster Howard S, Mittelman Moshe
Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.
MDS Center, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.
J Clin Med. 2023 Sep 9;12(18):5865. doi: 10.3390/jcm12185865.
Quality of life is impaired in MDS, but the role of hemoglobin level is unclear. To study the Hb-QoL correlation at diagnosis and 1 year later, patients filled out the EQ-5D questionnaire, assessing their mobility, self care, daily activities, pain/discomfort, and anxiety/depression, using scores of 0 (normal), 1 (mild/moderate), or 2 (poor). They also evaluated their health using a visual analogue scale, scoring from 0 (poor) to 100 (excellent). The anemia subgroups were: none/normal (Hb ≥ 12.5 g/dL), mild (10 ≤ Hb < 12.5), moderate (9 ≤ Hb < 10), severe (8 ≤ Hb < 9), or very severe (Hb < 8). LR-MDS patients (n = 127) and inpatient controls (n = 141) participated. The anemic patients had a poor QoL and the MDS patients had a lower QoL with a lower Hb. The controls had no QoL difference among the various anemia subgroups. In addition, the MDS QoL sharply decreased with an Hb of < 9. The MDS patients showed a wide QoL variability, i.e., different QoL scores in the same Hb subgroup, suggesting that other factors affect QoL (e.g., age and comorbidities). After 1 year (n = 61), the QoL was still poor for most MDS patients (including 27 patients with an increased Hb). In summary: (1) a poor QoL in MDS-anemia is non-linear, suggesting other influencing factors on QoL. (2) The sharp QoL drop with Hb < 9 g/dL challenges the transfusion Hb threshold. (3) The QoL in anemic MDS patients might differ from that in non-MDS patients. (4) Raising Hb, while recommended, does not guarantee an improved QoL.
骨髓增生异常综合征（MDS）患者的生活质量受损，但血红蛋白水平在其中的作用尚不清楚。为研究诊断时及1年后血红蛋白水平与生活质量（QoL）的相关性，患者填写了EQ - 5D问卷，评估其行动能力、自我护理、日常活动、疼痛/不适以及焦虑/抑郁情况，评分分别为0（正常）、1（轻度/中度）或2（差）。他们还使用视觉模拟量表评估自身健康状况，评分范围为0（差）至100（优）。贫血亚组分类如下：无/正常（血红蛋白≥12.5 g/dL）、轻度（10≤血红蛋白＜12.5）、中度（9≤血红蛋白＜10）、重度（8≤血红蛋白＜9）或极重度（血红蛋白＜8）。127例低危MDS患者（LR - MDS）和141例住院对照者参与了研究。贫血患者的生活质量较差，MDS患者中血红蛋白水平较低者生活质量更低。对照组在不同贫血亚组之间生活质量无差异。此外，当血红蛋白＜9时，MDS患者的生活质量急剧下降。MDS患者的生活质量存在很大差异，即在同一血红蛋白亚组中生活质量评分不同，这表明其他因素（如年龄和合并症）会影响生活质量。1年后（n = 61），大多数MDS患者的生活质量仍然较差（包括27例血红蛋白升高的患者）。总之：（1）MDS - 贫血患者生活质量差呈非线性，提示存在其他影响生活质量的因素。（2）血红蛋白＜9 g/dL时生活质量急剧下降，对输血血红蛋白阈值提出了挑战。（3）贫血MDS患者的生活质量可能与非MDS患者不同。（4）虽然推荐提高血红蛋白水平，但这并不能保证生活质量得到改善。
