Thread by @TransfusionWM

Prof David Bowen from Leeds talking on MDS. QOL so important in these patients. EQ5D is used to assess this but new tools in development. Compliance with completing assessments is 85%. A motivated group! #BSH2019

Novel ways to diagnose MDS without a marrow looking at blood glucose, creatinine and other markers. Could be very powerful. Marrow considered gold standard but even then diagnosis is not clear cut #BSH2019

Change in platelet count of 25% at 6 months is prognostic. If also become transfusion dependent in that time, median survival is 2y. Work from Raphael Itzykson in Paris #BSH2019

Refining prognosis for individual patients is important. Transfusion dependence is associated with poorer survival. Transfusion also associated with poorer QOL #BSH2019

ESA works best prior to transfusion dependence but not licensed in this cohort #BSH2019

Iron chelation may be useful. TELESTO is the only RCT; Exjade vs placebo. Did not recruit well and cannot answer the question. But ferritin lower in the Exjade group and also fewer events but full paper awaited #BSH2019

Labile plasma iron is higher in MDS with sideroblasts. These patients have a lower survival rate and may benefit most from chelation #BSH2019

Retrospective analysis of chelated vs non. Chelated pts were younger and fitter. With propensity matching a strong survival advantage for chelation is shown. Not an RCT but the best data there are available #BSH2019

MDS Europe has a great resource for MDS with ELN guidelines; management guidelines will be live in a few months
mds-europe.eu
#BSH2019