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Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome

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Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome. / Garelius, H K G; Johnston, William Thomas; Smith, Alexandra Gwen; Park, S; de Swart, L; Fenaux, P; Symeonidis, A; Sanz, G; Cermak, J; Stauder, R; Malcovati, L; van de Loosdrecht, A A; van Marrewijk, C J ; Bowen, David; Crouch, Simon; de Witte, T J M; Hellstrom-Lindberg, E.

In: Journal of general internal medicine, Vol. 281, No. 3, 07.12.2016, p. 284-299.

Research output: Contribution to journalArticle

Harvard

Garelius, HKG, Johnston, WT, Smith, AG, Park, S, de Swart, L, Fenaux, P, Symeonidis, A, Sanz, G, Cermak, J, Stauder, R, Malcovati, L, van de Loosdrecht, AA, van Marrewijk, CJ, Bowen, D, Crouch, S, de Witte, TJM & Hellstrom-Lindberg, E 2016, 'Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome', Journal of general internal medicine, vol. 281, no. 3, pp. 284-299. https://doi.org/10.1111/joim.12579

APA

Garelius, H. K. G., Johnston, W. T., Smith, A. G., Park, S., de Swart, L., Fenaux, P., ... Hellstrom-Lindberg, E. (2016). Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome. Journal of general internal medicine, 281(3), 284-299. https://doi.org/10.1111/joim.12579

Vancouver

Garelius HKG, Johnston WT, Smith AG, Park S, de Swart L, Fenaux P et al. Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome. Journal of general internal medicine. 2016 Dec 7;281(3):284-299. https://doi.org/10.1111/joim.12579

Author

Garelius, H K G ; Johnston, William Thomas ; Smith, Alexandra Gwen ; Park, S ; de Swart, L ; Fenaux, P ; Symeonidis, A ; Sanz, G ; Cermak, J ; Stauder, R ; Malcovati, L ; van de Loosdrecht, A A ; van Marrewijk, C J ; Bowen, David ; Crouch, Simon ; de Witte, T J M ; Hellstrom-Lindberg, E. / Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome. In: Journal of general internal medicine. 2016 ; Vol. 281, No. 3. pp. 284-299.

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@article{d767c59511a942d48ec28744680652c5,
title = "Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome",
abstract = "Background The EUMDS registry is an unique prospective, longitudinal observational registry enrolling newly diagnosed patients with lower‐risk myelodysplastic syndrome (MDS) from 17 European countries from both university hospitals and smaller regional hospitals. Objective The aim of this study was to describe the usage and clinical impact of erythropoiesis‐stimulating agents (ESAs) in 1696 patients enrolled between 2008 and 2014. Methods The effects of ESAs on outcomes were assessed using proportional hazards models weighting observations by propensity to receive ESA treatment within a subset of anaemic patients with or without a regular transfusion need. Results ESA treatment (median duration of 27.5 months, range 0–77 months) was administered to 773 patients (45.6{\%}). Outcomes were assessed in 897 patients (484 ESA treated and 413 untreated). ESA treatment was associated with a nonsignificant survival benefit (HR 0.82, 95{\%} CI: 0.65–1.04, P = 0.09); this benefit was larger amongst patients without prior transfusions (P = 0.07). Amongst 539 patients for whom response to ESA treatment could be defined, median time to first post‐ESA treatment transfusion was 6.1 months (IQR: 4.3–15.9 months) in those transfused before ESA treatment compared to 23.3 months (IQR: 7.0–47.8 months) in patients without prior transfusions (HR 2.4, 95{\%} CI: 1.7–3.3, P < 0.0001). Responding patients had a better prognosis in terms of a lower risk of death (HR 0.65, 95{\%} CI: 0.45–0.893, P = 0.018), whereas there was no significant effect on the risk of progression to acute myeloid leukaemia (HR 0.71, 95{\%} CI: 0.39–1.29, P = 0.27). Conclusion Appropriate use of ESAs can significantly delay the onset of a regular transfusion need in patients with lower‐risk MDS.",
keywords = "MDS, Myelodysplasia, anaemia, haematology, haemoglobin",
author = "Garelius, {H K G} and Johnston, {William Thomas} and Smith, {Alexandra Gwen} and S Park and {de Swart}, L and P Fenaux and A Symeonidis and G Sanz and J Cermak and R Stauder and L Malcovati and {van de Loosdrecht}, {A A} and {van Marrewijk}, {C J} and David Bowen and Simon Crouch and {de Witte}, {T J M} and E Hellstrom-Lindberg",
note = "{\circledC} 2016 The Authors",
year = "2016",
month = "12",
day = "7",
doi = "10.1111/joim.12579",
language = "English",
volume = "281",
pages = "284--299",
journal = "Journal of general internal medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "3",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Erythropoiesis-stimulating agents significantly delay the onset of a regular transfusion need in nontransfused patients with lower-risk myelodysplastic syndrome

AU - Garelius, H K G

AU - Johnston, William Thomas

AU - Smith, Alexandra Gwen

AU - Park, S

AU - de Swart, L

AU - Fenaux, P

AU - Symeonidis, A

AU - Sanz, G

AU - Cermak, J

AU - Stauder, R

AU - Malcovati, L

AU - van de Loosdrecht, A A

AU - van Marrewijk, C J

AU - Bowen, David

AU - Crouch, Simon

AU - de Witte, T J M

AU - Hellstrom-Lindberg, E

N1 - © 2016 The Authors

PY - 2016/12/7

Y1 - 2016/12/7

N2 - Background The EUMDS registry is an unique prospective, longitudinal observational registry enrolling newly diagnosed patients with lower‐risk myelodysplastic syndrome (MDS) from 17 European countries from both university hospitals and smaller regional hospitals. Objective The aim of this study was to describe the usage and clinical impact of erythropoiesis‐stimulating agents (ESAs) in 1696 patients enrolled between 2008 and 2014. Methods The effects of ESAs on outcomes were assessed using proportional hazards models weighting observations by propensity to receive ESA treatment within a subset of anaemic patients with or without a regular transfusion need. Results ESA treatment (median duration of 27.5 months, range 0–77 months) was administered to 773 patients (45.6%). Outcomes were assessed in 897 patients (484 ESA treated and 413 untreated). ESA treatment was associated with a nonsignificant survival benefit (HR 0.82, 95% CI: 0.65–1.04, P = 0.09); this benefit was larger amongst patients without prior transfusions (P = 0.07). Amongst 539 patients for whom response to ESA treatment could be defined, median time to first post‐ESA treatment transfusion was 6.1 months (IQR: 4.3–15.9 months) in those transfused before ESA treatment compared to 23.3 months (IQR: 7.0–47.8 months) in patients without prior transfusions (HR 2.4, 95% CI: 1.7–3.3, P < 0.0001). Responding patients had a better prognosis in terms of a lower risk of death (HR 0.65, 95% CI: 0.45–0.893, P = 0.018), whereas there was no significant effect on the risk of progression to acute myeloid leukaemia (HR 0.71, 95% CI: 0.39–1.29, P = 0.27). Conclusion Appropriate use of ESAs can significantly delay the onset of a regular transfusion need in patients with lower‐risk MDS.

AB - Background The EUMDS registry is an unique prospective, longitudinal observational registry enrolling newly diagnosed patients with lower‐risk myelodysplastic syndrome (MDS) from 17 European countries from both university hospitals and smaller regional hospitals. Objective The aim of this study was to describe the usage and clinical impact of erythropoiesis‐stimulating agents (ESAs) in 1696 patients enrolled between 2008 and 2014. Methods The effects of ESAs on outcomes were assessed using proportional hazards models weighting observations by propensity to receive ESA treatment within a subset of anaemic patients with or without a regular transfusion need. Results ESA treatment (median duration of 27.5 months, range 0–77 months) was administered to 773 patients (45.6%). Outcomes were assessed in 897 patients (484 ESA treated and 413 untreated). ESA treatment was associated with a nonsignificant survival benefit (HR 0.82, 95% CI: 0.65–1.04, P = 0.09); this benefit was larger amongst patients without prior transfusions (P = 0.07). Amongst 539 patients for whom response to ESA treatment could be defined, median time to first post‐ESA treatment transfusion was 6.1 months (IQR: 4.3–15.9 months) in those transfused before ESA treatment compared to 23.3 months (IQR: 7.0–47.8 months) in patients without prior transfusions (HR 2.4, 95% CI: 1.7–3.3, P < 0.0001). Responding patients had a better prognosis in terms of a lower risk of death (HR 0.65, 95% CI: 0.45–0.893, P = 0.018), whereas there was no significant effect on the risk of progression to acute myeloid leukaemia (HR 0.71, 95% CI: 0.39–1.29, P = 0.27). Conclusion Appropriate use of ESAs can significantly delay the onset of a regular transfusion need in patients with lower‐risk MDS.

KW - MDS

KW - Myelodysplasia

KW - anaemia

KW - haematology

KW - haemoglobin

UR - http://www.scopus.com/inward/record.url?scp=85008252451&partnerID=8YFLogxK

U2 - 10.1111/joim.12579

DO - 10.1111/joim.12579

M3 - Article

VL - 281

SP - 284

EP - 299

JO - Journal of general internal medicine

T2 - Journal of general internal medicine

JF - Journal of general internal medicine

SN - 0884-8734

IS - 3

ER -