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

Area of Science:

• Hematology
• Transfusion Medicine
• Epidemiology

Background:

• Real-world data on transfusion requirements in myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML) are limited.
• The introduction of disease-modifying therapies (DMTs) like 5-azacitidine in 2011 and patient blood management (PBM) guidelines may have influenced transfusion needs.

Purpose of the Study:

• To describe the burden of red blood cell (RBC-T) and platelet (PLT-T) transfusions in MDS/CMML patients.
• To evaluate changes in transfusion burden following the implementation of funded DMTs and PBM guidelines in 2011.

Main Methods:

• A retrospective longitudinal cohort study was conducted using linked datasets from Victoria, Australia (2009-2022).
• The study included all patients diagnosed with MDS or CMML, analyzing hospital admissions, cancer registries, and death registries.

Main Results:

• The study analyzed 7043 patients (5715 MDS; 1328 CMML) with a median follow-up of 1.8 years, documenting 55,048 RBC-T and 10,749 PLT-T episodes.
• By 5 years post-diagnosis, patients averaged 14 RBC-T and 3 PLT-T admissions, with transfusion burden varying by MDS subtype.
• Significantly more PLT-T admissions occurred post-2011 compared to pre-2011 (0.8 additional admissions by 2 years, p < 0.001), while RBC-T admissions remained stable.

Conclusions:

• Red blood cell transfusion burden in MDS/CMML patients has remained consistent since 2011.
• Platelet transfusion requirements have significantly increased post-2011, posing challenges for blood supply and inventory management.
• Further research is crucial to optimize platelet transfusion strategies for MDS/CMML patients, considering cost and resource implications.