Impact of red blood cell transfusion dose density on progression-free survival in patients with lower-risk myelodysplastic syndromes
Impact of red blood cell transfusion dose density on progression-free survival in patients with lower-risk myelodysplastic syndromes
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DOI：
10.3324/haematol.2018.212217
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发表时间：
2020-03-01
期刊：
影响因子：
10.1
通讯作者：
de Witte, Theo
中科院分区：
文献类型：
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作者：
de Swart, Louise;Crouch, Simon;de Witte, Theo
接受红细胞输注治疗的低风险骨髓增生异常综合征（MDS）患者的无进展生存期（PFS）通常会降低，但目前尚不清楚输注剂量密度是否是一个独立的预后因素。欧洲MDS登记处每6个月从16个欧洲国家和以色列新诊断的低风险骨髓增生异常综合征患者中收集前瞻性数据。使用具有时变协变量的比例风险回归分析输血剂量密度数据-每个间期结束时接受的累积剂量除以自接受首次输血的间期开始的时间-以死亡和进展为高风险MDS/急性髓性白血病事件。在纳入分析的1，267例患者中，317例死亡，无进展; 162例患者的疾病进展。PFS与年龄、EQ-5D指数、基线世界卫生组织分类、骨髓原始细胞计数、细胞遗传学风险类别、血细胞减少数量和国家显著相关。输血剂量密度与PFS呈负相关（P
Progression-free survival (PFS) of patients with lower-risk myelodysplastic syndromes (MDS) treated with red blood cell transfusions is usually reduced, but it is unclear whether transfusion dose density is an independent prognostic factor. The European MDS Registry collects prospective data at 6-monthly intervals from newly diagnosed lower-risk myelodysplastic syndromes patients in 16 European countries and Israel. Data on the transfusion dose density - the cumulative dose received at the end of each interval divided by the time since the beginning of the interval in which the first transfusion was received - were analyzed using proportional hazards regression with time-varying co-variates, with death and progression to higher-risk MDS/acute myeloid leukemia as events. Of the 1,267 patients included in the analyses, 317 died without progression; in 162 patients the disease had progressed. PFS was significantly associated with age, EQ-5D index, baseline World Health Organization classification, bone marrow blast count, cytogenetic risk category, number of cytopenias, and country. Transfusion dose density was inversely associated with PFS (P