A Prospective Evaluation of Impact of Disease, Treatment, Sex, and Race Disparities on Quality of Life and Financial Toxicity in Patients with Myelodysplastic Syndromes

• Published in: Blood 2024-11, Vol.144, p.532-532
• Main Authors: Ball, Somedeb, Al Ali, Najla H., Jain, Akriti G., Shahzad, Moazzam, Whiting, Junmin, Lastorino, Daniel, Xie, Zhuoer, Walker, Alison R., Chan, Onyee, Padron, Eric, Kim, Jongphil, Lancet, Jeffrey E, Sallman, David, Tinsley-Vance, Sara M., Komrokji, Rami S.
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-209273

Introduction Myelodysplastic syndrome (MDS) is primarily seen in non-Hispanic (NH) White males. Hence, data is scarce on race and sex disparities in patients (pts) with MDS. Pt-reported quality of life (QoL) is considered a clinically meaningful endpoint in MDS clinical trials; however, knowledge is lacking on impact of various pt, disease, and treatment-related factors on QoL and financial burden. Here we report the data from a prospective study evaluating potential predictors of QoL and financial toxicity in MDS, with particular reference to pt sex and race. Methods In this single-center prospective observational study, eligible consenting pts with MDS completed two surveys at 4-month interval. We assessed pt QoL with the Quality of Life in Myelodysplasia Scale (QUALMS), a validated MDS-specific 38-item tool, with potential score range of 0 (worst) to 100 (best). Financial burden was evaluated with 12-item Comprehensive Score for financial Toxicity (COST) questionnaire, with score range of 0 (worst) to 44 (best). Electronic medical records were reviewed to collect relevant clinical data on pts. Results From April 2022 till November 2023, we accrued 117 pts with MDS, including 72 (61.5%) male and 45 (38.5%) female pts. Overall, 88 (75%) were White, 14 (12%) Black, 7 (6%) identified as Asian; and 21 (18%) were Hispanics (H). Median age at diagnosis was 69 years. Median hemoglobin (Hb) level was 9.5 gm/dL and 30% of pts were transfusion dependent. Overall, 22% of pts had higher-risk disease by revised international prognostic scoring system. Common mutations included SF3B1 (30%), TP53 (19%), TET2 (18%), and ASXL1 (18%). At baseline, pts were on observation (Obs) (27%), erythropoiesis stimulating agents (ESA) (13%), luspatercept (Luspa) (9%), lenalidomide (Len) (5%), hypomethylating agent (HMA)-based therapy (27%), or clinical trial (11%). Mean baseline QUALMS score was 62 (range, 22-100) and COST score was 25.5 (range, 0-44) in the study pts. Female pts were younger at diagnosis than males (median age- 65.5 vs. 71.5 years; p