SERUM ERYTHROPOIETIN (SEPO) TESTING, LEVELS, AND SUBSEQUENT TREATMENT PATTERNS FOR TRANSFUSION-DEPENDENT PATIENTS WITH MYELODYSPLASTIC SYNDROMES (MDS)
(Abstract release date: 05/19/16)
EHA Library. Gerds A. 06/09/16; 134817; PB1917
Dr. Aaron T. Gerds
Contributions
Contributions
Abstract
Abstract: PB1917
Type: Publication Only
Background
The European Society for Medical Oncology and the National Comprehensive Cancer Network have developed guidelines for the treatment of MDS, describing sEPO level as a useful measure at initial evaluation and for supporting decisions about whether to treat with erythropoietin-stimulating agents (ESAs). A high pre-treatment sEPO level is associated with a lack of response to ESAs, and therefore patients with high sEPO levels should be considered for other therapies.
Aims
To evaluate rates of sEPO testing and sEPO levels, and the subsequent use of ESAs among patients who became transfusion-dependent (TD) at or after MDS diagnosis.
Methods
A retrospective chart review of patients with MDS was conducted in the US. 26 oncologists and hematologists provided data from sequential patient charts. Patient inclusion criteria were: age ≥ 18 years, diagnosis of International Prognostic Scoring System Low/Intermediate-risk MDS within the last 1–5 years, and TD onset ≥ 12 months previously. Patients who had high-risk disease prior to TD onset, had a concurrent malignancy, or were in an MDS clinical trial were excluded. Demographics, disease history, treatment history, and lab values were collected and reported descriptively. Results were compared using chi-square tests.
Results
Information was collected on 133 TD MDS patients. 57.9% were male and median age was 67 years (range 37–89), with a median of 25 months since diagnosis (range 12–58). 66 (49.6%) patients had an sEPO test at diagnosis; of these, 39.4% had levels ≥ 200 mU/mL, including 13.6% ≥ 500 mU/mL. For patients without sEPO testing, reasons included practice dynamics (28.4%), testing not considered worthwhile (28.4%), and no intent for ESA use (17.9%). Excluding this latter group, 21.8% of untested patients were treated with ESA vs 36.4% of those tested (P = 0.08).
Conclusion
Of US patients with TD MDS, only half had undergone sEPO testing at diagnosis. Many had sEPO ≥ 200mU/mL, including a proportion with ≥ 500 mU/mL; alternative treatments to ESAs should be considered for these patients. Nevertheless, ESA use occurred in nearly a fifth of patients not tested at diagnosis, suggesting that expanded sEPO testing may identify additional patients not appropriate for ESAs.
Session topic: E-poster
Keyword(s): Erythropoietin, MDS
Type: Publication Only
Background
The European Society for Medical Oncology and the National Comprehensive Cancer Network have developed guidelines for the treatment of MDS, describing sEPO level as a useful measure at initial evaluation and for supporting decisions about whether to treat with erythropoietin-stimulating agents (ESAs). A high pre-treatment sEPO level is associated with a lack of response to ESAs, and therefore patients with high sEPO levels should be considered for other therapies.
Aims
To evaluate rates of sEPO testing and sEPO levels, and the subsequent use of ESAs among patients who became transfusion-dependent (TD) at or after MDS diagnosis.
Methods
A retrospective chart review of patients with MDS was conducted in the US. 26 oncologists and hematologists provided data from sequential patient charts. Patient inclusion criteria were: age ≥ 18 years, diagnosis of International Prognostic Scoring System Low/Intermediate-risk MDS within the last 1–5 years, and TD onset ≥ 12 months previously. Patients who had high-risk disease prior to TD onset, had a concurrent malignancy, or were in an MDS clinical trial were excluded. Demographics, disease history, treatment history, and lab values were collected and reported descriptively. Results were compared using chi-square tests.
Results
Information was collected on 133 TD MDS patients. 57.9% were male and median age was 67 years (range 37–89), with a median of 25 months since diagnosis (range 12–58). 66 (49.6%) patients had an sEPO test at diagnosis; of these, 39.4% had levels ≥ 200 mU/mL, including 13.6% ≥ 500 mU/mL. For patients without sEPO testing, reasons included practice dynamics (28.4%), testing not considered worthwhile (28.4%), and no intent for ESA use (17.9%). Excluding this latter group, 21.8% of untested patients were treated with ESA vs 36.4% of those tested (P = 0.08).
Conclusion
Of US patients with TD MDS, only half had undergone sEPO testing at diagnosis. Many had sEPO ≥ 200mU/mL, including a proportion with ≥ 500 mU/mL; alternative treatments to ESAs should be considered for these patients. Nevertheless, ESA use occurred in nearly a fifth of patients not tested at diagnosis, suggesting that expanded sEPO testing may identify additional patients not appropriate for ESAs.
Session topic: E-poster
Keyword(s): Erythropoietin, MDS
Abstract: PB1917
Type: Publication Only
Background
The European Society for Medical Oncology and the National Comprehensive Cancer Network have developed guidelines for the treatment of MDS, describing sEPO level as a useful measure at initial evaluation and for supporting decisions about whether to treat with erythropoietin-stimulating agents (ESAs). A high pre-treatment sEPO level is associated with a lack of response to ESAs, and therefore patients with high sEPO levels should be considered for other therapies.
Aims
To evaluate rates of sEPO testing and sEPO levels, and the subsequent use of ESAs among patients who became transfusion-dependent (TD) at or after MDS diagnosis.
Methods
A retrospective chart review of patients with MDS was conducted in the US. 26 oncologists and hematologists provided data from sequential patient charts. Patient inclusion criteria were: age ≥ 18 years, diagnosis of International Prognostic Scoring System Low/Intermediate-risk MDS within the last 1–5 years, and TD onset ≥ 12 months previously. Patients who had high-risk disease prior to TD onset, had a concurrent malignancy, or were in an MDS clinical trial were excluded. Demographics, disease history, treatment history, and lab values were collected and reported descriptively. Results were compared using chi-square tests.
Results
Information was collected on 133 TD MDS patients. 57.9% were male and median age was 67 years (range 37–89), with a median of 25 months since diagnosis (range 12–58). 66 (49.6%) patients had an sEPO test at diagnosis; of these, 39.4% had levels ≥ 200 mU/mL, including 13.6% ≥ 500 mU/mL. For patients without sEPO testing, reasons included practice dynamics (28.4%), testing not considered worthwhile (28.4%), and no intent for ESA use (17.9%). Excluding this latter group, 21.8% of untested patients were treated with ESA vs 36.4% of those tested (P = 0.08).
Conclusion
Of US patients with TD MDS, only half had undergone sEPO testing at diagnosis. Many had sEPO ≥ 200mU/mL, including a proportion with ≥ 500 mU/mL; alternative treatments to ESAs should be considered for these patients. Nevertheless, ESA use occurred in nearly a fifth of patients not tested at diagnosis, suggesting that expanded sEPO testing may identify additional patients not appropriate for ESAs.
Session topic: E-poster
Keyword(s): Erythropoietin, MDS
Type: Publication Only
Background
The European Society for Medical Oncology and the National Comprehensive Cancer Network have developed guidelines for the treatment of MDS, describing sEPO level as a useful measure at initial evaluation and for supporting decisions about whether to treat with erythropoietin-stimulating agents (ESAs). A high pre-treatment sEPO level is associated with a lack of response to ESAs, and therefore patients with high sEPO levels should be considered for other therapies.
Aims
To evaluate rates of sEPO testing and sEPO levels, and the subsequent use of ESAs among patients who became transfusion-dependent (TD) at or after MDS diagnosis.
Methods
A retrospective chart review of patients with MDS was conducted in the US. 26 oncologists and hematologists provided data from sequential patient charts. Patient inclusion criteria were: age ≥ 18 years, diagnosis of International Prognostic Scoring System Low/Intermediate-risk MDS within the last 1–5 years, and TD onset ≥ 12 months previously. Patients who had high-risk disease prior to TD onset, had a concurrent malignancy, or were in an MDS clinical trial were excluded. Demographics, disease history, treatment history, and lab values were collected and reported descriptively. Results were compared using chi-square tests.
Results
Information was collected on 133 TD MDS patients. 57.9% were male and median age was 67 years (range 37–89), with a median of 25 months since diagnosis (range 12–58). 66 (49.6%) patients had an sEPO test at diagnosis; of these, 39.4% had levels ≥ 200 mU/mL, including 13.6% ≥ 500 mU/mL. For patients without sEPO testing, reasons included practice dynamics (28.4%), testing not considered worthwhile (28.4%), and no intent for ESA use (17.9%). Excluding this latter group, 21.8% of untested patients were treated with ESA vs 36.4% of those tested (P = 0.08).
Conclusion
Of US patients with TD MDS, only half had undergone sEPO testing at diagnosis. Many had sEPO ≥ 200mU/mL, including a proportion with ≥ 500 mU/mL; alternative treatments to ESAs should be considered for these patients. Nevertheless, ESA use occurred in nearly a fifth of patients not tested at diagnosis, suggesting that expanded sEPO testing may identify additional patients not appropriate for ESAs.
Session topic: E-poster
Keyword(s): Erythropoietin, MDS
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