Longitudinal Changes in Transfusion Practice in Myelodysplastic Syndromes: A Population Data-Linkage Study.
Key claim: In a Victorian population cohort of MDS/CMML patients (2009–2022), red-cell transfusion burden remained stable after 2011 while platelet transfusions increased, varying by subtype and affecting blood-supply planning.
Abstract
BACKGROUND: Real-world data on transfusion needs of patients with myelodysplastic syndromes (MDS), and the impacts of disease-modifying therapies (DMTs) are sparse. In 2011, 5-azacitidine became the first funded DMT for MDS and chronic myelomonocytic leukaemia (CMML) patients in Australia and national patient blood management (PBM) guidelines were published. AIMS: Describe red blood cell transfusion (RBC-T) and platelet transfusion (PLT-T) burden in MDS/CMML and any changes since 2011. METHOD: Retrospective longitudinal cohort study of all MDS/CMML patients in the state of Victoria (population 6.5 million) from 2009 to 2022, linking hospital admissions dataset, cancer and death registries. RESULTS: 7043 patients (5715 MDS; 1328 CMML), with median follow-up 1.8 years (interquartile range [IQR]: 0.5-4.0 years), had 55 048 RBC-T and 10 749 PLT-T episodes. By 5 years post-diagnosis, patients had on average 14 RBC-T and 3 PLT-T admissions, with transfusion burden affected by MDS subtype. PLT-T were significantly higher post-2011 versus pre-2011 (0.8 more PLT-T admissions by 2 years, p < 0.001), with no difference in RBC-T admissions. CONCLUSION: Since 2011, RBC-T burden has remained stable, but PLT-Ts have increased. Given the potential costs and limited PLT inventories, this impacts blood supply planning and highlights the need for research to optimise PLT-T in MDS/CMML patients.
Why this matters
In a Victorian population cohort of MDS/CMML patients (2009–2022), red-cell transfusion burden remained stable after 2011 while platelet transfusions increased, varying by subtype and affecting blood-supply planning.