Outcome of Myelodysplastic Syndromes Over Time in the United States: A National Cancer Data Base Study From 2004-2013

Mayo Clin Proc. 2019 Aug;94(8):1467-1474. doi: 10.1016/j.mayocp.2019.02.029.

Abstract

Objective: To study the changes in overall outcome of patients with myelodysplastic syndromes (MDSs) after approval of several treatments.

Patients and methods: We identified 54,953 MDS cases in the National Cancer Data Base diagnosed from January 1, 2004, through December 31, 2013, using International Classification of Diseases for Oncology, 3rd edition, codes 9980, 9982-9983, 9985-9987, 9989, 9991-9992. Overall survival and different subgroups were studied over 3 periods of diagnoses (2004-2006, 2007-2009, and 2010-2013).

Results: Median age at diagnosis was 76 years. The most common subtype was MDS-unclassifiable, which represented 55.6% of all cases. We found that males, older patients, patients with refractory anemia with excess blasts, Medicare insurance recipients, and those treated at nonacademic centers had the worse survival (P<.001). Overall survival did not improve over time, except in younger patients (<40 years old).

Conclusion: In the past decade, overall outcome of MDS did not improve despite the advent of new therapies. More studies are needed to understand the impact of newly approved treatments on the outcome of patients with MDS.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cause of Death*
  • Combined Modality Therapy
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / diagnosis
  • Myelodysplastic Syndromes / mortality*
  • Myelodysplastic Syndromes / therapy*
  • Outcome Assessment, Health Care*
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Sex Factors
  • Statistics, Nonparametric
  • Survival Analysis
  • United States