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. 2022 Oct;109(4):381-387.
doi: 10.1111/ejh.13820. Epub 2022 Jul 6.

Management of infection prophylaxis in Dutch patients with myelodysplastic syndromes, a web-based case vignette questionnaire: The MINDSET study

Johanne Rozema  1   2 , Eric van Roon  1   2 , Lars Vogelzang  1 , Robby Kibbelaar  3 , Nic Veeger  4   5 , Arjan van de Loosdrecht  6 , Mels Hoogendoorn  7
Affiliations

Management of infection prophylaxis in Dutch patients with myelodysplastic syndromes, a web-based case vignette questionnaire: The MINDSET study

Johanne Rozema et al. Eur J Haematol. 2022 Oct.

Abstract

Objectives: Infections are a major cause of morbidity and mortality in patients with myelodysplastic syndromes (MDS). The objective of the MINDSET study was to evaluate haematologists' management of infection prevention in MDS patients using a case vignette study and to assess the availability of guidelines.

Methods: We conducted a web-based, nationwide survey amongst haematologists in the Netherlands between September and December 2021. The survey included a set of case vignettes. In addition, the availability of protocols was evaluated.

Results: Sixty responses were obtained (23.6%). These responses were well distributed across hospital types as well as level of experience. No protocols regarding infection prophylaxis specifically for MDS patients were received. In the case vignette of a 75-year-old MDS patient, respondents would primarily prescribe infection prophylaxis in case of recurrent infections (96.7%) and neutropenia (75.0% for absolute neutrophil count [ANC] < 0.2 × 109 /L and 53.3% for ANC < 0.5 × 109 /L), especially in combination with hypomethylating agents (80.0%), lenalidomide (66.7%) or chemotherapy (51.7%). Respondents would predominantly choose antibacterial agents (85.0%), followed by antifungal agents (71.7%).

Conclusions: This study showed diverse reasons and considerations of haematologists regarding whether to prescribe infection prophylaxis in MDS patients. Given the seriousness of infections in MDS patients, patient-tailored recommendations might be valuable in clinical decision-making.

Keywords: anti-infective agent; infections; myelodysplastic syndromes; prophylaxis; survey.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The answers to the question ‘Which patient‐related factors do you keep in mind when prescribing infection prophylaxis in MDS patients?’ (A) List of possible patient‐related factors. (B) Specification of ‘other’
FIGURE 2
FIGURE 2
The answers to the question ‘Based on what information would you prescribe infection prophylaxis in MDS patients?’ †In case a guideline for another haemato‐oncological disease was chosen, 31 respondents (51.7%) would use the guideline for AML and five (8.3%) would opt for a different guideline. ‡In case respondents chose ‘other’: 8 respondents (57.1%) based their decision on individual consideration, 1 respondent (7.1%) on the SmPC of Azacitidine and 5 respondents (35.7%) would not prescribe standard prophylaxis
FIGURE 3
FIGURE 3
The answers to the question ‘You see a 75‐year‐old patient diagnosed with MDS. In which situation would you prescribe infection prophylaxis?’
See this image and copyright information in PMC

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