Myelodysplastic syndrome survival and secondary AML trends in the United States.

Abstract

7552 Background: Myelodysplastic syndrome (MDS) is a rare heterogeneous group of hematologic stem cell disorders. The most recent FDA therapies approved for the treatment of MDS were decitabine (May 2006), lenalidomide (June 2005), and azacitidine (November 2004). This analysis utilized a population-based cancer registry to identify changes in survival rates and secondary AML rates among patients with MDS. Methods: SEER 18 regions database (November 2017 submission) was accessed to obtain data on survival and secondary malignancies using SEER*Stat 8.3.6. ICD-O-3 codes were used to identify patients with refractory anemia (RA), refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, refractory cytopenia with multilineage dysplasia, MDS with 5q deletion, therapy-related MDS, and MDS, not otherwise specified. An observed survival analysis was conducted using a cohort diagnosed between 2001 and 2004 and another diagnosed between 2009 and 2012. Secondary AML risk was calculated using multiple primary - standardized incidence ratios (MP-SIR) to obtain observed/expected (O/E) ratio. Results: Three-year observed survival rates for patients diagnosed between 2001 and 2004 was 53.2% (50.4%, 55.9%) and was 61.2% (57.9%, 64.3%) for patients diagnosed between 2009 and 2012. There was no observed survival difference among other MDS subtypes. O/E ratio for development of AML among patients with RA was 2.77 (0.57, 8.11) for patients diagnosed between 2001 and 2004, and 49.49 (33.39, 70.65) for patients diagnosed between 2009 and 2012. Conclusions: Survival among patients diagnosed with RA has improved in recent years, whereas survival among other subtypes of MDS has not changed. Secondary AML rates have increased among RA patients identified in the population-based cancer registry.