A validated decision model for treating the anaemia of myelodysplastic syndromes with erythropoietin plus granulocyte colony-stimulating factor: significant effects on quality of life

E Hellstrom-Lindberg, N Gulbrandsen, G Lindberg, T Ahlgren, IMS Dahl, I Dybedal, G Grimfors, E Hesse-Sundin, M Hjorth, L Kanter-Lewensohn, O Linder, M Luthman, E Lofvenberg, G Oberg, A Porwit-MacDonald, A Radlund, Jannica Samuelsson Johannesson, JM Tangen, I Winquist, F Wisloff

Research output: Contribution to journalArticlepeer-review

Abstract

We have published previously a prototype of a decision model for anaemic patients with myelodysplastic syndromes (MDS), in which transfusion need and serum erythropoietin (S-Epo) were used to define three groups with different probabilities of erythroid response to treatment with granulocyte colony-stimulating factor (G-CSF) + Epo. S-Epo less than or equal to 500 U/l and a transfusion need of < 2 units/month predicted a high probability of response to treatment, S-Epo > 500 U/l and greater than or equal to 2 units/month for a poor response, whereas the presence of only one negative prognostic marker predicted an intermediate response. A total of 53 patients from a prospective study were included in our evaluation sample. Patients with good or intermediate probability of response were treated with G-CSF + Epo. The overall response rate was 42% with 28.3% achieving a complete and 13.2% a partial response to treatment. The response rates were 61% and 14% in the good and intermediate predictive groups respectively. The model retained a significant predictive value in the evaluation sample (P < 0.001). Median duration of response was 23 months. Scores for global health and quality of life (QOL) were significantly lower in MDS patients than in a reference population, and fatigue and dyspnoea was significantly more prominent. Global QOL improved in patients responding to treatment (P = 0.01). The validated decision model defined a subgroup of patients with a response rate of 61% (95% confidence interval 48-74%) to treatment with G-CSF + Epo. The majority of these patients have shown complete and durable responses.
Original languageEnglish
Pages (from-to)1037-1046
JournalBritish Journal of Haematology
Volume120
Issue number6
DOIs
Publication statusPublished - 2003

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Division of Hematology and Transfusion Medicine (013041100), Emergency medicine/Medicine/Surgery (013240200)

Subject classification (UKÄ)

  • Hematology

Free keywords

  • granulocyte colony-stimulating factor
  • anaemia
  • erythropoietin
  • myelodysplasia

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