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Updated: May 4, 2026
Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
Published on: October 3, 2018
Transfusion dependence development and disease evolution in patients with MDS and del(5q) and without transfusion
Silvia M Rojas1, María Díez-Campelo1, Elisa Luño2
1Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain.
Abstract:
Patients with isolated del(5q) and MDS are considered to have good prognosis as compared to other MDS subtypes. Most patients suffered of anemia and 50% of them required transfusions at diagnosis. It is known that for patients with MDS and del(5q) in transfusion dependence(TD), Lenalidomide is the first choice treatment. However, there are no data regarding natural evolution of anemia in patients diagnosed in MDS and del(5q) without TD, factors that may impact on the development of TD or disease outcome. In the present study we have performed a retrospective multicenter analysis on 83 patients with low-int 1 MDS and del(5q) without TD. During the study 61 patients became TD at a median of 1.7 years and only the Hb level 9 g/dL was associated with poorer TFS (p = 0.007) in the multivariate analysis. Among these 61 TD patients, 49 received treatment (19 Lenalidomide). Median follow up was 48 months, estimated OS at 2 and 5 year was 92% and 50% respectively. In the multivariate analysis for OS, platelets <100,000 mm(-3) and Lenalidomide treatment retained the statistical significant impact. LFS at 2 and 5 years was 86% and 73% respectively, and median time to sAML was 8.16 years (CI 95%: 6.05-10.27). In the multivariate analysis only thrombocytopenia retained statistical significance. In summary, this retrospective study show that level of Hb is an important parameter in order to determine the time until TD, it should be also stressed the importance of an early treatment in order to prevent TD development and shorter survival.
Insights
Patients with myelodysplastic syndromes and del(5q) without transfusion dependence often develop anemia. Lower hemoglobin levels predict time to transfusion dependence, emphasizing early treatment for better outcomes.
Area of Science:
- Hematology
- Oncology
- Clinical Research
Background:
- Myelodysplastic syndromes (MDS) with isolated del(5q) typically have a good prognosis.
- Anemia is common in these patients, with 50% requiring transfusions at diagnosis.
- Lenalidomide is the standard treatment for transfusion-dependent MDS with del(5q), but data on non-transfusion-dependent cases are limited.
Purpose of the Study:
- To investigate the natural evolution of anemia in patients with low-int 1 MDS and del(5q) without transfusion dependence.
- To identify factors influencing the development of transfusion dependence and disease outcomes.
- To evaluate the impact of early treatment on transfusion dependence and survival.
Main Methods:
- Retrospective multicenter analysis of 83 patients with low-int 1 MDS and del(5q) without transfusion dependence.
- Analysis of hemoglobin levels, time to transfusion dependence, overall survival (OS), and leukemia-free survival (LFS).
- Multivariate analysis to identify significant prognostic factors.
Main Results:
- 61 patients (73%) developed transfusion dependence at a median of 1.7 years.
- Hemoglobin level below 9 g/dL was associated with poorer time to transfusion dependence (TFS).
- For transfusion-dependent patients, lower platelet counts and Lenalidomide treatment impacted OS, while thrombocytopenia affected LFS.
Conclusions:
- Hemoglobin level is a key predictor for time to transfusion dependence in MDS with del(5q).
- Early intervention may prevent transfusion dependence and improve survival.
- Further research into optimal treatment strategies for non-transfusion-dependent MDS with del(5q) is warranted.
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