High serum ferritin levels in newly diagnosed patients with myelodysplastic syndromes are associated with greater symptom severity

Springer Science and Business Media LLC - 2020
Giovanni Caocci1, Marco Vignetti2, Andrea Patriarca3, Massimo Breccia4, Uwe Platzbecker5, Giuseppe A. Palumbo6, Reinhard Stauder7, Francesco Cottone2, Duska Petranovic8, Maria Teresa Voso9, Agostino Tafuri10, Rosangela Invernizzi11, Jo Caers12, Mario Luppi13, Giorgio La Nasa1, Pasquale Niscola14, Fabio Efficace2
1Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
2Data Center and Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA), Rome, Italy
3Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
4Department of Cellular Biotechnologies and Hematology, Division of Hematology, Sapienza University, Rome, Italy
5Clinic and Policlinic of Hematology and Cellular Therapy, Oncology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
6Dipartimento di Scienze Mediche, Chirurgiche E Tecnologie Avanzate “G.F. Ingrassia”, University of Catania, Catania, Italy
7Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
8Department of Hematology, Clinical Hospital Center Rijeka, Rijeka, Croatia
9Department of Biomedicine and Prevention, Università di Roma “Tor Vergata”, Rome, Italy
10Azienda Ospedaliera Sant' Andrea, Rome, Italy
11Department of Internal Medicine, San Matteo IRCCS Policlinic Foundation, University of Pavia, Pavia, Italy
12Department of Hematology, CHU de Liège, University of Liege, Liege, Belgium
13Department of Medical and Surgical Sciences, Chair of Hematology, AOU Modena, University of Modena and Reggio Emilia, Modena, Italy
14Hematology Unit, Sant’Eugenio Hospital, Rome, Italy

Tóm tắt

We examined the association between serum ferritin (SF) levels and patient-reported functional aspects and symptoms, as measured by the EORTC QLQ-C30, in newly diagnosed patients with myelodysplastic syndromes (MDS). Analysis was conducted on 497 MDS patients who were classified in two groups based on the SF value of 1000 ng/mL. Clinically relevant differences of patient-reported functional and symptom scales were evaluated and classified as small, medium and large, based on established thresholds. Multivariable linear regression analysis was performed to account for potential confounding factors. Patients with SF of ≥ 1000 ng/mL reported statistically significant and clinically relevant worse outcomes across various health domains. Dyspnea was the symptom indicating the largest difference and mean scores of patients with higher and lower SF levels were 40 and 24.3, respectively (p = 0.005), indicating a large clinically relevant difference (Δ = 15.7). Further research is needed to better understand the relationship between SF levels and specific health-related quality of life domains.

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Tài liệu tham khảo

Lefèvre C, Bondu S, Le Goff S, Kosmider O, Fontenay M. Dyserythropoiesis of myelodysplastic syndromes. Curr Opin Hematol. 2017;24(3):191–7.

Lyle L, Hirose A. Iron Overload in myelodysplastic syndromes: pathophysiology, consequences, diagnosis, and treatment. J Adv Pract Oncol. 2018;9(4):392–405.

Isidori A, Borin L, Elli E, Latagliata R, Martino B, Palumbo G, et al. Iron toxicity - Its effect on the bone marrow. Blood Rev. 2018;32(6):473–9.

Gattermann N. Iron overload in myelodysplastic syndromes (MDS). Int J Hematol. 2018;107(1):55–63.

Wood JC. Guidelines for quantifying iron overload. Hematol Am Soc Hematol Edu. 2014;2014(1):210–5.

Malcovati L, Hellstrom-Lindberg E, Bowen D, Ades L, Cermak J, Del Canizo C, et al. Diagnosis and treatment of primary myelodysplastic syndromes in adults: recommendations from the European LeukemiaNet. Blood. 2013;122(17):2943–64.

Caocci G, La Nasa G, Efficace F. Health-related quality of life and symptom assessment in patients with myelodysplastic syndromes. Expert Rev Hematol. 2009;2(1):69–80.

Lyons RM, Marek BJ, Paley C, Esposito J, McNamara K, Richards PD, et al. Relation between chelation and clinical outcomes in lower-risk patients with myelodysplastic syndromes: registry analysis at 5 years. Leuk Res. 2017;56:88–95.

Efficace F, Santini V, La Nasa G, Cottone F, Finelli C, Borin L, et al. Health-related quality of life in transfusion-dependent patients with myelodysplastic syndromes: a prospective study to assess the impact of iron chelation therapy. BMJ Support Palliat Care. 2016;6(1):80–8.

Efficace F, Cottone F, Oswald LB, Cella D, Patriarca A, Niscola P, et al. The IPSS-R more accurately captures fatigue severity of newly diagnosed patients with myelodysplastic syndromes compared with the IPSS index. Leukemia. 2020;2:13–7. https://doi.org/10.1038/s41375-41020-40746-41378.

Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76.

Cocks K, King MT, Velikova G, Martyn St-James M, Fayers PM, Brown JM. Evidence-based guidelines for determination of sample size and interpretation of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. J Clin Oncol. 2011;29(1):89–96.

Fozza C, La Nasa G, Caocci G. The Yin and Yang of myelodysplastic syndromes and autoimmunity: the paradox of autoimmune disorders responding to therapies specific for MDS. Crit Rev Oncol Hematol. 2019;142:51–7.

Stauder R, Yu G, Koinig KA, Bagguley T, Fenaux P, Symeonidis A, et al. Health-related quality of life in lower-risk MDS patients compared with age- and sex-matched reference populations: a European LeukemiaNet study. Leukemia. 2018;32(6):1380–92.

Efficace F, Gaidano G, Breccia M, Criscuolo M, Cottone F, Caocci G, et al. Prevalence, severity and correlates of fatigue in newly diagnosed patients with myelodysplastic syndromes. Br J Haematol. 2015;168(3):361–70.

Hoeks M, Yu G, Langemeijer S, Crouch S, de Swart L, Fenaux P, et al. Impact of treatment with iron chelation therapy in patients with lower-risk myelodysplastic syndromes participating in the European MDS registry. Haematologica. 2020;105(3):640–51.

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