PB1924: ARE WE TAKING ADVANTAGE OF THERAPEUTIC OPTIONS IN MYELODYSPLASTIC SYNDROME?-REAL WORLD DATA FROM HUNGARY

Abstract

Background: The majority of patients with myelodysplasia (MDS) are over 70 years of age, so the only curative treatment, allogeneic stem cell transplantation, can be given to only a few patients. However, treatments available in recent years (lenalidomide, azacitidine, erythropoietin) may improve both quality of life and survival, so it is important to identify and treat these patients where possible. Aims: Analysis of the characteristics, treatment modalities, and survival outcomes of our MDS patients. Methods: Data from MDS patients diagnosed and treated at our department were analyzed retrospectively between January 1, 2010 and December 31, 2020. We compared the characteristics of patients treated before and after 2015 and their treatment. Allogeneic transplantation, azacitidine, lenalidomide and erythropoietin treatment were considered active treatments. Transfusions, GCSF, and chelating agents were considered supportive treatments. Results: A total of 341 patients had confirmed MDS during this period, with a mean age of 69.52 (23-95) years and a median survival of 31.77 (0-385) months. 56% of patients were older than 70 years at diagnosis and only 8% were younger than 50 years. The most common histological subtype (44.57% of patients) wasrefractory cytopenia with multilineage dysplasia. Based on IPSS, 78% of patients were in the low and intermediate 1 risk groups. 78% of patients already required transfusion at diagnosis and 55% of all patients received supportive care only. While 39% of patients diagnosed before 2015 received active treatment alone, 51% of patients in the group diagnosed after 2015 already received active treatment (p=0.061). 40% of patients died and an additional 35% were lost from follow-up. Overall survival of patients in the low and intermedier-1 group was significantly better than the intermedier-2 and high risk group (p=0.000). Until 2015 the survival of actively treated patients was worse, in the period after 2015 an improving trend can already be observed, which is more due to the low and intermedier-1 risk patients thanks to the available active treatment. Image:Summary/Conclusion: Although the only curative treatment remains the allogeneic transplantation in MDS, therapies have become available with therapies available since 2015. For this reason, we must strive for the earliest and most accurate diagnosis possible.