ATLANTA—In patients with low- and intermediate-risk myelodysplastic syndromes (MDS) who have regularly received transfusions, chelation therapy improves survival, according to a study presented at ASH 2007 (abstract 249).
Christian Rose, MD, of the Hôpital Saint Vincent de Paul Catholic University, Lille, France, noted that red blood cell transfusions are required in most patients with MDS, leading to iron overload, which in turn is associated with diminished survival. Survival benefits in MDS for chelation therapy have been suggested in two retrospective studies.
Dr. Rose and his colleagues therefore conducted a prospective analysis of 170 MDS patients who were referred for blood transfusions at 18 centers over a 1-month period. Survival was analyzed at 2 years.
Most of the patients fell into the International Prognostic Scoring System (IPSS) low (27%) or intermediate1 (32%) category; 10% were categorized as intermediate2, and 2% as high (rating unavailable in 29%).
Of the 79 patients who received chelation: 57 received “standard” chelation with deferioxamine, deferasirox(Drug information on deferasirox) (Exjade), deferiprone(Drug information on deferiprone), or deferioxamine plus deferiprone, while 19 received “low” chelation with deferioxamine.
Median survival from diagnosis to time of death was significantly longer for the patients who received 6 months or more of chelation than for those not receiving chelation (115 months vs 51 months, P < .0001). The benefit was consistent across low and intermediate1 groups, and across gender and age categories. Further, median survival was 120 months vs 69 months for standard- intensity chelation, compared with low chelation (P < .001).