The use of iron chelation therapy for transfusion dependent myelodysplastic syndrome patients: a cross-sectional study in Belgium

M. Delforge, D. Selleslag, A Triffet, P. Mineur, G. Bries, C. Graux, Fabienne Trullemans, D. Boulet, K. Van Eygen, Yves Beguin, Luc Noens, S. Van Steenweghen, J. Lemmens, M. Petrick, P. Pierre, R. D'hondt, D. Deeren, A. Ferrant, A. Van De Velde, W. WynendaeleM. Andre, R. De Bock, A. Efira, D. Beems, A. Deweweire, K. Geldhof, W. Pluymers, C. Ravoet

Research output: Chapter in Book/Report/Conference proceedingMeeting abstract (Book)

Abstract

Background
Almost all patients with MDS are likely to receive red blood cell (RBC) transfusions at some time, and in 40% this is the sole therapeutic option that can be offered. There is a lack of information on MDS patient characteristics and treatment patterns in Belgium. Therefore a cross-sectional observational study was conducted aiming to assess treatment patterns of transfusion-dependent MDS patients in Belgium. Patients were identified from 29 Belgian hematology centers. Transfusion dependence was defined as having received at least one RBC transfusion every 8 weeks over a period of 4 months prior to inclusion.
Results
During the 2 month recruitment period a cohort of 193 transfusion dependent MDS patients was identified. Median age was 76 y (range 44-103). The average number of RBC units transfused in the past 4 months was 12 (range 2-40). Transfusion need was higher in patients with higher compared to lower IPSS scores. From the 176 patients with available serum ferritin values, 126 (65%)had levels above 1000 µg/L. 90 patients (47%) received iron chelation therapy with either Deferoxamine or Deferasirox. No difference in age was reported between chelated and non-chelated patients. In 56 of the 92 non-chelated patients reported serum ferritin values were above 1000µ?g/L. 74% of these 56 patients had IPSS scores of Low to Intermediate 1, and therefore potential candidates for iron chelation therapy, according to international recommendations. The main reasons why patients did not receive iron chelation treatment were: age, limited life expectancy, comorbidities, and Desferal administration considered as too cumbersome.
Summary
This Belgian cross-sectional study identified 193 transfusion dependent MDS patients with valuable information concerning treatment patterns. Many patients did not receive iron chelation therapy for various reasons, although they were suitable candidates. A further follow-up of the identified patient cohort is planned.
Original languageEnglish
Title of host publication25th General Meeting of the Belgian Hematological Society - Abstract Oral Presentation p 36
PublisherBelgian Hematological Society
Publication statusPublished - 29 Jan 2010

Keywords

  • myelodysplastic syndrome
  • iron chelation therapy
  • RBC transfusion

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