Patients with myelodysplastic syndromes with ring sideroblasts showed clinically meaningful excess mortality compared with matched general population controls.
The study, led by Pina Gabriela Gálvez Zavala Registro, of Universidad Peruana Cayetano Heredia in Lima, Peru, compared patients in the Spanish Group of Myelodysplastic Syndromes (GESMD) national MDS registry with matched general population data to characterize relative survival and mortality outcomes for RS–positive MDS.
The analysis included 2,095 patients with MDS with 15% or greater RS or 5% or greater RS plus SF3B1 mutation, and less than 5% bone marrow blasts and less than 2% peripheral blood blasts. Over a median follow-up of 31.6 months, 784 deaths occurred. Observed overall survival was 91.9% at one year, 76.1% at three years, and 60.8% at five years in patients with MDS, while expected survival in the matched Spanish general population was approximately 96% at one year, 88.4% at three years, and 82.1% at five years.
A platelet level below 100×109/L was linked to inferior five-year relative survival (41.7% vs 77.7%; P=1.06×10-9). For very good or good, intermediate, and poor or very poor risk cytogenetic subgroups, five-year relative survival was 81.8%, 75.9%, and 48.4%, respectively (P=.0009). Transfusion dependence (excess hazard ratio [EHR], 2.44; 95% CI, 1.22-4.86), intermediate-risk cytogenetics (EHR, 4.75; 95% CI, 2.04-11.03), and poor or very poor-risk cytogenetics (EHR, 13.71; 95% CI, 5.82-32.33) were independently associated with higher excess mortality.
Overall, MDS with RS was associated with excess mortality compared with general controls, and “transfusion dependence and adverse cytogenetics refine risk stratification beyond blast percentage,” the authors concluded.
The analysis will be presented at the Fourteenth Annual Meeting of the Society of Hematologic Oncology in Houston, Texas, during the poster session on Wednesday, September 9.
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