MDS-RS患者的特征在于慢性贫血和急性髓系白血病(AML)进展的低风险,并且他们通常变为红细胞(RBC)输血依赖性(TD)。
我们在100名MDS-RSTD患者中进行了6个月的回顾性“现实生活”观察研究,在12个法国中心招募,为了描述输血特征,评估住院的频率和原因,医疗费用,和发病率,与输血依赖有关,在法国RBC输血依赖性MDS-RS患者人群中。
79%的患者具有高输血负担(HTB)和21%的低输血负担(LTB)。HTB患者的疾病持续时间较长(6vs.3.7年,p=0.0078),更频繁的铁螯合(82%vs.50%,p=0.0052)和更高的血清铁蛋白(p=0.03)。在6个月的研究期间,22%的患者需要住院,其中36%为有症状的贫血,需要紧急红细胞输血。6个月的输血费用中位数,包括日托设施的费用,往返医院的交通,铁螯合,和实验室测试,16188欧元/患者。
MDS-RS代表慢性低危MDS的原型类型。这些患者中的大多数都有很高的输血负担,因此经常需要去医院的日托设施,频繁住院,总体中位数治疗成本较高。应将这些费用与可能避免RBC输血依赖并减少MDS-RS患者慢性贫血并发症的新疗法的费用进行比较。
MDS-RS patients are characterized by chronic anemia and a low risk of Acute Myeloid Leukemia (AML) progression and they generally become Red Blood Cell (RBC) transfusion dependent (TD).
We performed a retrospective \"real-life\" observational study of 6 months in 100 MDS-RS TD patients, recruited in 12 French centers, to describe transfusion characteristics, and evaluate the frequency and causes of hospitalizations, health costs, and morbidity, associated with transfusion dependency, in a French population of RBC transfusion-dependent MDS-RS patients.
79% of the patients had high transfusion burden (HTB) and 21% low transfusion burden (LTB). HTB patients had a longer disease duration (6 vs. 3.7 years, p = 0.0078), more frequent iron chelation (82% vs. 50%, p = 0.0052) and higher serum ferritin (p = 0.03). During the 6-month study period, 22% of the patients required inpatient hospitalization, 36% of them for symptomatic anemia requiring emergency RBC transfusion. The 6-month median transfusion costs, including the cost of the day care facility, transportation to and from the hospital, iron chelation, and lab tests, was 16,188€/patient.
MDS-RS represents the archetypal type of chronically transfused lower-risk MDS. Most of those patients have a high transfusion burden and thus frequently need visits to the hospital\'s day care facility, and frequent hospitalizations, with an overall high median treatment cost. Those costs should be compared with costs of new treatments potentially able to avoid RBC transfusion dependence and to reduce the complications of chronic anemia in MDS-RS patients.