The following article features coverage from the American Society of Clinical Oncology 2020 meeting. Click here to read more of Hematology Advisor’s conference coverage.

Survival of patients with refractory anemia (RA) has improved over the past several years, though this improvement has not been seen in other myelodysplastic syndrome (MDS) subtypes, according to research presented during the ASCO20 Virtual Scientific Program.

MDS, a heterogenous set of hematologic stem cell disorders, has had 3 major US Food and Drug Administration approvals since 2004 (decitabine in 2006, lenalidomide in 2005, and azacitidine in 2004). Whether these approvals have changed survival rates among patients with MDS or affected the rates of secondary acute myeloid leukemia (AML) has not been previously established.

For this study, researchers evaluated data from a population-based registry to determine survival differences between patients diagnosed with MDS from 2001 to 2004 and those diagnosed from 2009 to 2012. Standardized incidence ratios were used to determine the risk for secondary AML.

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Data from patients with 1 of the following MDS subtypes were reviewed: RA, RA with ringed sideroblasts, RA with excess blasts, RA with excess blasts in transformation, refractory cytopenia with multilineage dysplasia, MDS with 5q deletion, therapy-related MDS, and MDS not otherwise specified.

Among patients diagnosed with RA between 2001 and 2004, 3-year survival rates were 53.2%, while those diagnosed between 2009 and 2013 had 3-year rates of 61.2%. There was no noted survival difference in any other MDS subtype.

The observed/expected (O/E) ratio for AML risk among patients with RA also increased between the evaluated periods, with an O/E of 2.77 among those diagnosed between 2001 and 2004 vs 49.49 among those diagnosed between 2009 and 2012.

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“Survival among patients diagnosed with RA has improved in recent years, whereas survival among other subtypes of MDS has not changed,” the authors wrote. “Secondary AML rates have increased among RA patients identified in the population-based cancer registry.”


Swenson WT, Swenson AP. Myelodysplastic syndrome survival and secondary AML trends in the United States. Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38:(suppl): abstr 7552.