Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data

Autor: Aslaner Ak M; Zonguldak Bülent Ecevit University Faculty of Medicine, Department of Hematology, Zonguldak, Türkiye, Gedük A; Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Türkiye, Acar İH; Çukurova University Faculty of Medicine, Department of Hematology, Adana, Türkiye, Polat MG; Kocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, Türkiye, Sunu C; Sakarya Training and Research Hospital, Clinic of Hematology, Sakarya, Türkiye, Bolaman AZ; Adnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, Türkiye, Hacıbekiroğlu T; Sakarya Training and Research Hospital, Clinic of Hematology, Sakarya, Türkiye, Güvenç B; Çukurova University Faculty of Medicine, Department of Hematology, Adana, Türkiye, Ertop Ş; Zonguldak Bülent Ecevit University Faculty of Medicine, Department of Hematology, Zonguldak, Türkiye
Jazyk: angličtina
Zdroj: Turkish journal of haematology : official journal of Turkish Society of Haematology [Turk J Haematol] 2023 May 29; Vol. 40 (2), pp. 92-100. Date of Electronic Publication: 2023 Feb 17.
DOI: 10.4274/tjh.galenos.2023.2022.0437
Abstrakt: Objective: This study was undertaken to evaluate the long-term clinical efficacy of epoetin alfa and darbepoetin alfa in patients with myelodysplastic syndrome (MDS) in a real-life setting.
Materials and Methods: A total of 204 patients with low-risk or intermediate-1-risk MDS who received epoetin alfa or darbepoetin alfa were included. Hemoglobin levels and transfusion needs were recorded before treatment and at 12 months, 24 months, 36 months, and 48 months of treatment.
Results: At the 36-month (p=0.025) and 48-month (p=0.022) visits, epoetin alfa yielded significantly higher hemoglobin levels compared to darbepoetin alfa. Transfusion needs were also significantly lower with epoetin alfa compared to darbepoetin alfa at 24 months (p=0.012) and in the low-risk group compared to the intermediate-risk group at 24 months (p=0.018), 36 months (p=0.025), and 48 months (p<0.001). Treatment response rates at the 24-month, 36-month, and 48-month visits in the epoetin alfa (43.0%, 33.6%, and 27.1%), darbepoetin alfa (29.9%, 22.7%, and 16.5%), low-risk (39.3%, 30.0%, and 26.0%), and intermediate-risk (29.6%, 24.1%, and 11.1%) groups were lower than those obtained at 12 months, and the values differed significantly for the 36-month and 48-month visits with values ranging from p<0.05 to p<0.001.
Conclusion: This real-life long-term ESA extension study investigated the clinical efficacy of epoetin alfa and darbepoetin alfa for up to 48 months, revealing that treatment efficacy reached a plateau starting from the 24 th month of therapy with a continuing decrease in treatment response rates regardless of treatment type, risk status, or gender. Nonetheless, significantly higher hemoglobin levels and marked improvement in transfusion needs were evident in epoetin-treated patients compared to darbepoetin-treated patients and in the low-risk group compared to the intermediate-risk group.
Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.
(©Copyright 2023 by Turkish Society of Hematology | Turkish Journal of Hematology, Published by Galenos Publishing House)
Databáze: MEDLINE
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