Quality of life, physical function and MRI T2*in elderly low-risk MDS patients treated to a haemoglobin level of >= 120 g/L with darbepoetin alfa +/- filgrastim or erythrocyte transfusions

Research output: Contribution to journalArticle

Abstract

Objective: Anaemia in low-risk MDS is associated with reduced quality of life (QoL). Response to treatment with erythropoietin (EPO) + G-CSF is associated with improved QoL, but whether transfusion therapy with higher haemoglobin (Hb) target levels has similar effects is unknown. The objective for this prospective phase II Nordic multicentre trial was to assess QoL, response rate and physical function in elderly anaemic MDS patients treated to a target Hb level of >120 g/l. Methods: Thirty-six elderly low- and intermediate-1 risk MDS patients received darbepoetin (DA) 300μg/week, with the addition of G-CSF if no response. If the Hb target was reached at 16 weeks, treatment was maintained until week 26. Remaining patients were transfused to reach the target level for at least 8 weeks. Results: Twenty-seven patients completed the study. Response rate to DA±G-CSF was 67% in evaluable patients and 56% according to intention-to-treat. Eighteen patients reached the target Hb level according to protocol. QoL scores for fatigue, dyspnoea, constipation, and physical, role and social functioning improved significantly during study, with similar results for transfused and untransfused patients. Maintaining Hb > 120 g/L did not confer a higher transfusion rate, once the target was reached. In two of fourteen patients MRI T2* indicated cardiac iron overload, however without association with ferritin levels. Conclusions: In elderly anemic MDS patients an increment in haemoglobin is associated with improved QoL, whether induced by growth factor treatment or transfusion therapy.

Details

Authors
  • H Nilsson-Ehle
  • G Birgegård
  • Jannica Samuelsson Johannesson
  • P Antunovic
  • Jan Astermark
  • H Garelius
  • L Engström
  • L Kjeldsen
  • Lars Nilsson
  • A Olsson
  • M Skov-Holm
  • J Wallvik
  • N Gulbrandsen
  • E Hellström-Lindberg
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology
Original languageEnglish
Pages (from-to)244-252
JournalEuropean Journal of Haematology
Volume87
Issue number3
Publication statusPublished - 2011
Publication categoryResearch
Peer-reviewedYes