Dr. Sekeres on the Goal of Transfusion Independence in Higher-Risk MDS

Mikkael A. Sekeres, MD, professor of medicine, chief, Division of Hematology, Leukemia Section, Sylvester Comprehensive Cancer Center, University of Miami Health System, discusses the goal of transfusion independence in higher-risk myelodysplastic syndromes (HR-MDS).

Most patients with HR-MDS present with profound cytopenias and often require blood or platelet transfusions before presenting to the clinic, Sekeres says. Additionally, around 80% of patients with HR-MDS will present with some degree of anemia or will develop anemia early in their disease course, Sekeres explains. Even after starting therapy, patients often continue to receive transfusions, Sekeres adds.

In HR-MDS, the efficacy of a regimen is measured by whether a patient achieves a complete response, as well as whether they achieve hematologic improvement, such as transfusion independence or reduction in transfusion frequency, Sekeres says. Initially, transfusion-dependent patients were considered transfusion independent if they achieved hematologic improvement and a subsequent 8-week period of transfusion independence, Sekeres says.

However, the criteria for transfusion independence were later revised to require a 16-week period of transfusion independence because the benefits of 8 weeks of transfusion independence did not outweigh the risks associated with intensive azacitidine, Sekeres concludes.