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

• Published in: British journal of haematology 2003-03, Vol.120 (6), p.1037-1046
• Main Authors: Hellström‐Lindberg, Eva, Gulbrandsen, Nina, Lindberg, Greger, Ahlgren, Tomas, Dahl, Inger Marie S., Dybedal, Ingunn, Grimfors, Gunnar, Hesse‐Sundin, Eva, Hjorth, Martin, Kanter‐Lewensohn, Lena, Linder, Olle, Luthman, Michaela, Löfvenberg, Eva, Öberg, Gunnar, Porwit‐MacDonald, Anja, Rådlund, Anders, Samuelsson, Jan, Tangen, Jon Magnus, Winquist, Ingemar, Wisloff, Finn
• Format: Article
• Language: English
• Subjects: Aged; Anaemia; Anemia - therapy; Anemia, Refractory - therapy; Anemia, Refractory, with Excess of Blasts - therapy; Anemia, Sideroblastic - therapy; Biological and medical sciences; Blood Transfusion; Blood. Blood coagulation. Reticuloendothelial system; Decision Support Techniques; Erythropoietin; Erythropoietin - therapeutic use; Female; Granulocyte colony-stimulating factor; Granulocyte Colony-Stimulating Factor - therapeutic use; Hematology; Humans; Male; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Myelodysplasia; Myelodysplastic syndromes; Myelodysplastic Syndromes - therapy; Pharmacology. Drug treatments; Prognosis; Prospective Studies; Quality of Life; Treatment Outcome
• ISSN: 0007-1048; 1365-2141; 1365-2141
• DOI: 10.1046/j.1365-2141.2003.04153.x

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 ≤ 500 U/l and a transfusion need of  500 U/l and ≥ 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