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A validated decision model for treating the anaemia of myelodysplastic syndromes with erythropoietin plus granulocyte colony-stimulating factor: significant effects on quality of life

Hellstrom-Lindberg, E; Gulbrandsen, N; Lindberg, G; Ahlgren, T; Dahl, IMS; Dybedal, I; Grimfors, G; Hesse-Sundin, E; Hjorth, M and Kanter-Lewensohn, L, et al. (2003) In British Journal of Haematology 120(6). p.1037-1046
Abstract
We have published previously a prototype of a decision model for anaemic patients with myelodysplastic syndromes (MDS), in which transfusion need and serum erythropoietin (S-Epo) were used to define three groups with different probabilities of erythroid response to treatment with granulocyte colony-stimulating factor (G-CSF) + Epo. S-Epo less than or equal to 500 U/l and a transfusion need of < 2 units/month predicted a high probability of response to treatment, S-Epo > 500 U/l and greater than or equal to 2 units/month for a poor response, whereas the presence of only one negative prognostic marker predicted an intermediate response. A total of 53 patients from a prospective study were included in our evaluation sample. Patients... (More)
We have published previously a prototype of a decision model for anaemic patients with myelodysplastic syndromes (MDS), in which transfusion need and serum erythropoietin (S-Epo) were used to define three groups with different probabilities of erythroid response to treatment with granulocyte colony-stimulating factor (G-CSF) + Epo. S-Epo less than or equal to 500 U/l and a transfusion need of < 2 units/month predicted a high probability of response to treatment, S-Epo > 500 U/l and greater than or equal to 2 units/month for a poor response, whereas the presence of only one negative prognostic marker predicted an intermediate response. A total of 53 patients from a prospective study were included in our evaluation sample. Patients with good or intermediate probability of response were treated with G-CSF + Epo. The overall response rate was 42% with 28.3% achieving a complete and 13.2% a partial response to treatment. The response rates were 61% and 14% in the good and intermediate predictive groups respectively. The model retained a significant predictive value in the evaluation sample (P < 0.001). Median duration of response was 23 months. Scores for global health and quality of life (QOL) were significantly lower in MDS patients than in a reference population, and fatigue and dyspnoea was significantly more prominent. Global QOL improved in patients responding to treatment (P = 0.01). The validated decision model defined a subgroup of patients with a response rate of 61% (95% confidence interval 48-74%) to treatment with G-CSF + Epo. The majority of these patients have shown complete and durable responses. (Less)
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published
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keywords
granulocyte colony-stimulating factor, anaemia, erythropoietin, myelodysplasia
in
British Journal of Haematology
volume
120
issue
6
pages
1037 - 1046
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • wos:000181633900015
  • pmid:12648074
  • scopus:0037353935
ISSN
0007-1048
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language
English
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yes
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eb6e71e7-d008-47da-87e6-57076c7f7886 (old id 316320)
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2007-08-03 09:13:59
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2018-06-17 03:45:58
@article{eb6e71e7-d008-47da-87e6-57076c7f7886,
  abstract     = {We have published previously a prototype of a decision model for anaemic patients with myelodysplastic syndromes (MDS), in which transfusion need and serum erythropoietin (S-Epo) were used to define three groups with different probabilities of erythroid response to treatment with granulocyte colony-stimulating factor (G-CSF) + Epo. S-Epo less than or equal to 500 U/l and a transfusion need of &lt; 2 units/month predicted a high probability of response to treatment, S-Epo &gt; 500 U/l and greater than or equal to 2 units/month for a poor response, whereas the presence of only one negative prognostic marker predicted an intermediate response. A total of 53 patients from a prospective study were included in our evaluation sample. Patients with good or intermediate probability of response were treated with G-CSF + Epo. The overall response rate was 42% with 28.3% achieving a complete and 13.2% a partial response to treatment. The response rates were 61% and 14% in the good and intermediate predictive groups respectively. The model retained a significant predictive value in the evaluation sample (P &lt; 0.001). Median duration of response was 23 months. Scores for global health and quality of life (QOL) were significantly lower in MDS patients than in a reference population, and fatigue and dyspnoea was significantly more prominent. Global QOL improved in patients responding to treatment (P = 0.01). The validated decision model defined a subgroup of patients with a response rate of 61% (95% confidence interval 48-74%) to treatment with G-CSF + Epo. The majority of these patients have shown complete and durable responses.},
  author       = {Hellstrom-Lindberg, E and Gulbrandsen, N and Lindberg, G and Ahlgren, T and Dahl, IMS and Dybedal, I and Grimfors, G and Hesse-Sundin, E and Hjorth, M and Kanter-Lewensohn, L and Linder, O and Luthman, M and Lofvenberg, E and Oberg, G and Porwit-MacDonald, A and Radlund, A and Samuelsson Johannesson, Jannica and Tangen, JM and Winquist, I and Wisloff, F},
  issn         = {0007-1048},
  keyword      = {granulocyte colony-stimulating factor,anaemia,erythropoietin,myelodysplasia},
  language     = {eng},
  number       = {6},
  pages        = {1037--1046},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {British Journal of Haematology},
  title        = {A validated decision model for treating the anaemia of myelodysplastic syndromes with erythropoietin plus granulocyte colony-stimulating factor: significant effects on quality of life},
  url          = {http://dx.doi.org/},
  volume       = {120},
  year         = {2003},
}