Longitudinal Changes in Transfusion Practice in Myelodysplastic Syndromes: A Population Data-Linkage Study

Real-world data on transfusion needs of patients with myelodysplastic syndromes (MDS), and the impacts of disease-modifying therapies (DMTs) are sparse. In 2011, 5-azacitidine became the first funded DMT for MDS and chronic myelomonocytic leukaemia (CMML) patients in Australia and national patient blood management (PBM) guidelines were published.

Describe red blood cell transfusion (RBC-T) and platelet transfusion (PLT-T) burden in MDS/CMML and any changes since 2011.

Retrospective longitudinal cohort study of all MDS/CMML patients in the state of Victoria (population 6.5 million) from 2009 to 2022, linking hospital admissions dataset, cancer and death registries.

7043 patients (5715 MDS; 1328 CMML), with median follow-up 1.8 years (interquartile range [IQR]: 0.5-4.0 years), had 55 048 RBC-T and 10 749 PLT-T episodes. By 5 years post-diagnosis, patients had on average 14 RBC-T and 3 PLT-T admissions, with transfusion burden affected by MDS subtype. PLT-T were significantly higher post-2011 versus pre-2011 (0.8 more PLT-T admissions by 2 years, p < 0.001), with no difference in RBC-T admissions.

Since 2011, RBC-T burden has remained stable, but PLT-Ts have increased. Given the potential costs and limited PLT inventories, this impacts blood supply planning and highlights the need for research to optimise PLT-T in MDS/CMML patients.