- Email: [email protected]
319 BASELINE CHARACTERISTICS AND THE INCIDENCE OF AUTO-IMMUNE HEMOLYTIC ANEMIA IN MYELODYSPLASTIC SYNDROME (MDS) PATIENTS
S158
Poster Presentations – 13th International Symposium on Myelodyspastic Syndromes / Leukemia Research 39 S1 (2015) S1–S166
319 BASELINE CHARACTERISTICS AND THE INCIDENCE OF AUTO-IMMUNE HEMOLYTIC ANEMIA IN MYELODYSPLASTIC SYNDROME (MDS) PATIENTS T.A. Simon1, T.D. Kou2, A. Gomez2, H.J. Simon3 1 Epidemiology, Bristol Myers Squibb, Pennington, USA; 2GPVE, Bristol Myers Squibb, Pennington, USA; 3medical, Physicians Research Center, Toms River, USA Background: Myelodysplastic syndrome (MDS) results in symptomatic anemia for many afflicted individuals. There are published case reports of auto-immune hemolytic anemia (A-IHA) however, the risk of A-IHA and baseline risk factors in MDS are not well characterized. Methods: Patients with a diagnosis of MDS and 2 comparison groups (patients with a diagnosis of lymphoma or rheumatoid arthritis(RA)) in the MarketScan Commercial and Supplemental Medicare databases between July 1st 2006 and July 31st 2012 were included. A 6 month baseline window was used to identify co-morbidities prior to the diagnosis of MDS, lymphoma or RA.The association was assessed using Chi square test and incidence rate (95% CI) of A-IHA was calculated for each group. Results: The estimated prevalence and incidence of MDS in the population was 0.01% and 0.066/1000 person-years respectively. 8,341 patients had a diagnosis of MDS, 58% female; 72% ≥ 60 years. Most common (≥20%) co-morbidities identified in the 6 month baseline period for each group are listed in Table 1. Table 2 presents the incidence rate of A-IHA by group. Conclusions: This is the first observational study that estimates the rate of A-IHA in MDS patients. Our observed incidence rate of A-IHA in MDS is 14/1000 person years, higher than the published general population rate of 0.008/1,000 person years. Published studies have suggested that autoimmune disease may play a role in MSD. A-IHA is rare, and maybe overlooked as a cause of anemia in patients with MDS.
320 RISK STRATIFICATION OF THERAPY-RELATED MYELODYSPLASTIC SYNDROMES (T-MDS): A REPORT ON BEHALF OF THE MDS CLINICAL RESEARCH CONSORTIUM R. Komrokji1, A. Zeidan2, N. Al Ali1, E. Padron1, J. Lancet1, D. Steensma3, A. Dezern4, G. Roboz5, E. Jabbour6, M. Sekeres7, G. Garcia-Manero6, A. List1 1 Malignant Hematology, Moffitt Cancer Center, Tampa, USA; 2Yale School of Medicine, Yale University, New Haven, USA; 3Medicine, Dana-Farber Cancer Institute, Boston, USA; 4Oncology, Johns Hopkins University, Baltimore, USA; 5Weill Cornell Medical College, Cornell University, New York, USA; 6Leukemia, MD Anderson Cancer Center, Houston, USA; 7Leukemia, Cleveland Clinic, Cleveland, USA Introduction: t-MDS is associated with inferior outcomes compared to de novo MDS (d-MDS). Risk stratification models developed for d-MDS, such as the International Prognostic Scoring System (IPSS), have not been validated int-MDS. The conventional wisdom that all t-MDS should be approached similarly to IPSS higher-risk MDS can be challenged by the clinical observation of
Table 1. Baseline characteristics.
Table 1. Baseline comorbidity (6 mo prior to index diagnosis date) MDS N= 8,341 N
Lymphoma N=116,610
%
N
%
RA N=208,397
P value
N
%
P value
17,283
8.3
<0.0001
Anaemia
4,734
56.8 16,442 14.1 <0.0001
Essential hypertension
3,669
44.0 40,232 34.5 <0.0001 44,992 21.6 <0.0001
Dyspnoea
2,467
29.6 16,233 13.9 <0.0001
Malaise
2,034
24.4 15,787 13.5 <0.0001 28,508 13.7 <0.0001
Chest pain
1,835
22.0 16,618 14.3 <0.0001 19,555 9.4
6,565
3.2
<0.0001
Hyperlipidaemia 1,661
19.9 22,036 18.9 0.0230
Haemato1,800 poietic neoplasm
21.6
0.9
<0.0001
Diabetes mellitus 1,782
21.4 19,203 16.5 <0.0001 19,958 9.6
<0.0001
3,140
39,740 19.1
<0.0001
2.7 <0.0001
1,858
0.056
Table 2. Number (%) and Incidence Rate of Auto-Immune Hemolytic Anemia in Select Populations MDS N= 8,341, py 10599
Number of A-IHA cases
Lymphoma N=116610, py 63379
RA N=208,397, py 432,505
N
%
IR
N
%
IR
N
%
IR
100
1.2
14.1 (12.216.4)
418
0.36
5.2 (4.75.8)
400
0.19
0.92 (0.81.0)
Table 2. Median OS of t-MDS compared to d-MDS based on several risk models
Poster Presentations – 13th International Symposium on Myelodyspastic Syndromes / Leukemia Research 39 S1 (2015) S1–S166
319 BASELINE CHARACTERISTICS AND THE INCIDENCE OF AUTO-IMMUNE HEMOLYTIC ANEMIA IN MYELODYSPLASTIC SYNDROME (MDS) PATIENTS T.A. Simon1, T.D. Kou2, A. Gomez2, H.J. Simon3 1 Epidemiology, Bristol Myers Squibb, Pennington, USA; 2GPVE, Bristol Myers Squibb, Pennington, USA; 3medical, Physicians Research Center, Toms River, USA Background: Myelodysplastic syndrome (MDS) results in symptomatic anemia for many afflicted individuals. There are published case reports of auto-immune hemolytic anemia (A-IHA) however, the risk of A-IHA and baseline risk factors in MDS are not well characterized. Methods: Patients with a diagnosis of MDS and 2 comparison groups (patients with a diagnosis of lymphoma or rheumatoid arthritis(RA)) in the MarketScan Commercial and Supplemental Medicare databases between July 1st 2006 and July 31st 2012 were included. A 6 month baseline window was used to identify co-morbidities prior to the diagnosis of MDS, lymphoma or RA.The association was assessed using Chi square test and incidence rate (95% CI) of A-IHA was calculated for each group. Results: The estimated prevalence and incidence of MDS in the population was 0.01% and 0.066/1000 person-years respectively. 8,341 patients had a diagnosis of MDS, 58% female; 72% ≥ 60 years. Most common (≥20%) co-morbidities identified in the 6 month baseline period for each group are listed in Table 1. Table 2 presents the incidence rate of A-IHA by group. Conclusions: This is the first observational study that estimates the rate of A-IHA in MDS patients. Our observed incidence rate of A-IHA in MDS is 14/1000 person years, higher than the published general population rate of 0.008/1,000 person years. Published studies have suggested that autoimmune disease may play a role in MSD. A-IHA is rare, and maybe overlooked as a cause of anemia in patients with MDS.
320 RISK STRATIFICATION OF THERAPY-RELATED MYELODYSPLASTIC SYNDROMES (T-MDS): A REPORT ON BEHALF OF THE MDS CLINICAL RESEARCH CONSORTIUM R. Komrokji1, A. Zeidan2, N. Al Ali1, E. Padron1, J. Lancet1, D. Steensma3, A. Dezern4, G. Roboz5, E. Jabbour6, M. Sekeres7, G. Garcia-Manero6, A. List1 1 Malignant Hematology, Moffitt Cancer Center, Tampa, USA; 2Yale School of Medicine, Yale University, New Haven, USA; 3Medicine, Dana-Farber Cancer Institute, Boston, USA; 4Oncology, Johns Hopkins University, Baltimore, USA; 5Weill Cornell Medical College, Cornell University, New York, USA; 6Leukemia, MD Anderson Cancer Center, Houston, USA; 7Leukemia, Cleveland Clinic, Cleveland, USA Introduction: t-MDS is associated with inferior outcomes compared to de novo MDS (d-MDS). Risk stratification models developed for d-MDS, such as the International Prognostic Scoring System (IPSS), have not been validated int-MDS. The conventional wisdom that all t-MDS should be approached similarly to IPSS higher-risk MDS can be challenged by the clinical observation of
Table 1. Baseline characteristics.
Table 1. Baseline comorbidity (6 mo prior to index diagnosis date) MDS N= 8,341 N
Lymphoma N=116,610
%
N
%
RA N=208,397
P value
N
%
P value
17,283
8.3
<0.0001
Anaemia
4,734
56.8 16,442 14.1 <0.0001
Essential hypertension
3,669
44.0 40,232 34.5 <0.0001 44,992 21.6 <0.0001
Dyspnoea
2,467
29.6 16,233 13.9 <0.0001
Malaise
2,034
24.4 15,787 13.5 <0.0001 28,508 13.7 <0.0001
Chest pain
1,835
22.0 16,618 14.3 <0.0001 19,555 9.4
6,565
3.2
<0.0001
Hyperlipidaemia 1,661
19.9 22,036 18.9 0.0230
Haemato1,800 poietic neoplasm
21.6
0.9
<0.0001
Diabetes mellitus 1,782
21.4 19,203 16.5 <0.0001 19,958 9.6
<0.0001
3,140
39,740 19.1
<0.0001
2.7 <0.0001
1,858
0.056
Table 2. Number (%) and Incidence Rate of Auto-Immune Hemolytic Anemia in Select Populations MDS N= 8,341, py 10599
Number of A-IHA cases
Lymphoma N=116610, py 63379
RA N=208,397, py 432,505
N
%
IR
N
%
IR
N
%
IR
100
1.2
14.1 (12.216.4)
418
0.36
5.2 (4.75.8)
400
0.19
0.92 (0.81.0)
Table 2. Median OS of t-MDS compared to d-MDS based on several risk models