Myelodysplastic syndrome (MDS) is a disease mostly associated with old age, however, it can also occur as a complication of anti-cancer treatment, including certain chemotherapies and/or radiation. This is called therapy-related MDS (t-MDS). When it happens it is often an aggressive disease and difficult to treat. MDS is a very heterogeneous group of diseases and to determine what the best treatment option is for a particular patient is challenging. Doctors are helped in this process by scoring systems that, based on the characteristics of the patient’s disease, help evaluate the seriousness of their disease and this in turn will give an indication as to how aggressive the treatment should be. Each scoring system uses slightly different characteristics. Most of these scoring systems, however, have never been used to evaluate t-MDS.
This study tested five different scoring systems for their ability to correctly evaluate the seriousness of t-MDS. In a retrospective study (i.e., a study that uses data from patients that have already been treated and from whom it is known whether they survived and for how long), 84 t-MDS patients treated with azacitidine were evaluated with 5 different scoring systems. A scoring system would work correctly if it would identify those patients with the longest survival as low-risk and, vise versa, those with the shortest survival as high-risk. This study showed that this was best predicted by “the Global M.D. Anderson risk model”. However, a larger, prospective study is needed to truly judge the value of using this scoring system on t-MDS patients treated with azacitidine. (A prospective study is a study in which the outcome of a patient is not known, but is predicted based on certain characteristics. Patients will be followed over time to determine if the prediction was correct.)
Research presented at the European Hematology Assocation annual meeting on treatment of therapy-related MDS and prediction of outcomes after stem cell transplantation for MDS