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

Research output: Contribution to journalArticle


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.


  • 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 areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology


  • granulocyte colony-stimulating factor, anaemia, erythropoietin, myelodysplasia
Original languageEnglish
Pages (from-to)1037-1046
JournalBritish Journal of Haematology
Issue number6
Publication statusPublished - 2003
Publication categoryResearch

Bibliographic 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)