RRSS #4 - Blood Product Use Among Persons with Myelodysplastic Syndrome - Seattle

骨髓增生异常综合征（MDS）包括一组异质性的恶性干细胞疾病，其特征在于发育异常和无效的血细胞产生（即，凋亡性死亡）和转化为急性白血病的可变风险。MDS患者通常需要血液制品，但血液制品在这些条件下使用的模式是未知的。近年来，MDS的新治疗（例如，沙利度胺、来那度胺）已经变得可用，其减少了对输血的需要。另一方面，随着时间的推移，MDS的管理变得更加积极，最值得注意的是通过使用生长因子（促红细胞生成素，G-CSF）和骨髓移植治疗晚期疾病。在许多情况下，特定治疗（包括积极的支持性护理）对患者生存的影响仍然未知。此外，文献中几乎没有MDS患者的大型基于人群的观察性研究。我们这项建议的主要目标是首先确定将西部华盛顿SEER记录与普吉特湾血液中心记录联系起来的可行性，其次，如果成功，确定21岁及以上诊断为MDS的人在诊断后使用血液制品的模式。

The myelodysplastic syndromes (MDS) comprise a heterogeneous group of malignant stem cell disorders characterized by dysplastic and ineffective blood cell production (i.e., apoptotic death) and a variable risk of transformation to acute leukemia. Patients with MDS often require blood products, yet the patterns of blood product use in persons with these conditions are unknown. In recent years, new treatments for MDS (e.g., thalidomide, lenalidomide) have become available that reduce the need for transfusions. On the other hand, management of MDS has become more aggressive over time, most notably through the use of growth factors (erythropoietin, G-CSF) and bone marrow transplant for advanced stage disease. In many cases, the impact of specific treatments¿including aggressive supportive care¿on patient survival remains unknown. Furthermore, the literature contains few large population-based observational studies of MDS patients. Our primary goals for this proposal are first to determine the feasibility of linking Western Washington SEER records with Puget Sound Blood Center records, and second, if successful, to determine patterns of blood product use following diagnosis for persons ages 21 and older diagnosed with MDS.