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Comparative Study
. 2018 Jun;32(6):1380-1392.
doi: 10.1038/s41375-018-0089-x. Epub 2018 Mar 6.

Health-related quality of life in lower-risk MDS patients compared with age- and sex-matched reference populations: a European LeukemiaNet study

Reinhard Stauder  1 , Ge Yu  2 , Karin A Koinig  3 , Tim Bagguley  2 , Pierre Fenaux  4 , Argiris Symeonidis  5 , Guillermo Sanz  6   7 , Jaroslav Cermak  8 , Moshe Mittelman  9 , Eva Hellström-Lindberg  10 , Saskia Langemeijer  11 , Mette Skov Holm  12 , Krzysztof Mądry  13 , Luca Malcovati  14 , Aurelia Tatic  15 , Ulrich Germing  16 , Aleksandar Savic  17 , Corine van Marrewijk  11 , Agnès Guerci-Bresler  18 , Elisa Luño  19 , Jackie Droste  11 , Fabio Efficace  20 , Alex Smith  2 , David Bowen  21 , Theo de Witte  22
Affiliations
Comparative Study

Health-related quality of life in lower-risk MDS patients compared with age- and sex-matched reference populations: a European LeukemiaNet study

Reinhard Stauder et al. Leukemia. 2018 Jun.

Abstract

In myelodysplastic syndromes (MDS), health-related quality of life (HRQoL) represents a relevant patient-reported outcome, which is essential in individualized therapy planning. Prospective data on HRQoL in lower-risk MDS remain rare. We assessed HRQOL by EQ-5D questionnaire at initial diagnosis in 1690 consecutive IPSS-Low/Int-1 MDS patients from the European LeukemiaNet Registry. Impairments were compared with age- and sex-matched EuroQol Group norms. A significant proportion of MDS patients reported moderate/severe problems in the dimensions pain/discomfort (49.5%), mobility (41.0%), anxiety/depression (37.9%), and usual activities (36.1%). Limitations in mobility, self-care, usual activities, pain/discomfort, and EQ-VAS were significantly more frequent in the old, in females, and in those with high co-morbidity burden, low haemoglobin levels, or red blood cells transfusion need (p < 0.001). In comparison to age- and sex-matched peers, the proportion of problems in usual activities and anxiety/depression was significantly higher in MDS patients (p < 0.001). MDS-related restrictions in the dimension mobility were most prominent in males, and in older people (p < 0.001); in anxiety/depression in females and in younger people (p < 0.001); and in EQ-VAS in women and in persons older than 75 years (p < 0.05). Patients newly diagnosed with IPSS lower-risk MDS experience a pronounced reduction in HRQoL and a clustering of restrictions in distinct dimensions of HRQoL as compared with reference populations.

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Conflict of interest statement

This study was carried out within the EUMDS Registry which is supported by Novartis Oncology. T. de Witte is the project leader and C. van Marrewijk is the project manager of the EUMDS Registry. Outside the funding by Novartis Oncology, the following co-authors report grants or personal fees: R. Stauder received research funding and honoraria from Celgene, Teva and Novartis. T. de Witte reports grants from Celgene, personal fees from Incyte, personal fees from Amgen, personal fees from Incyte outside the submitted work. G. Sanz reports personal fees by Celgene. M. Mittelmann reports personal fees by Ofizer, Amgen, research grants by Celgene/Neopharm, and advisory roles for Celgene, Amgen, and Janssen. A. Savic personal fees by Seattle Genetics, Novo Nordisk, and Amgen. F. Efficace reports personal fees by Bristol-Myers Squibb, Seattle Genetics, TEVA and Incyte; and research funding by Lundbeck, TEVA, and Amgen. The remaining authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Proportion of moderate/severe problems in male (a) and female (b) patients with MDS (blue bars) as compared to European age- and sex-matched standard population (dark grey). Standard errors indicated as lines. Differences (∆) of patients with MDS to sex-matched reference group shown when significant (*** p < 0.001; **p < 0.01; *p < 0.05; as assessed by Wilcoxon signed rank tests)
Fig. 2
Fig. 2
Proportion of moderate/severe problems by age group (<60 (a), 60–75 (b), or >75 (c) years old) in patients with MDS (blue bars) as compared to European age- and sex-matched standard population (dark grey). Standard errors indicated as lines. Differences (∆) of patients with MDS to sex-matched reference group shown when significant (***p < 0.001; **p < 0.01; *p < 0.05; as assessed by Wilcoxon signed rank tests)
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