Source: Vaccine  |  Posted 5 years ago

By Bruce Sylvester

ORLANDO, FL -- December 12, 2006 -- Patients with myelodysplastic syndromes (MDS) who are treated with iron chelation therapy (ICT) achieved a significant improvement in overall survival after 4 years on this therapy, according to research reported here at the 48[^]th[] Annual Meeting of the American Society of Hematology (ASH).

"To our knowledge these are the first data documenting improvement in clinical outcome in patients with MDS who received ICT," said lead investigator and presenter Heather Leitch, MD, PhD, clinical assistant professor, University of British Columbia, Vancouver, British Columbia, Canada.

Dr. Leitch and colleagues conducted a retrospective review of 178 patients who had a bone marrow diagnosis of MDS and were seen at St. Paul s Hospital in Vancouver, Canada, from January 1981 to April 2006. The researchers collected clinical data from the practice database, the Iron Chelation Program of British Columbia database, and by chart review.

They applied the International Prognostic Scoring System (IPSS) and predicted the course of MDS in 44 patients classified as low risk, 55 classified as intermediate-1 risk, 17 intermediate-2 risk patients, and 17 at high risk. They also assessed the data for elevated levels of ferritin -- an iron-carrying protein -- and clinical evidence of iron overload.

At a media briefing on December 11[^]th[], Dr. Leitch presented results for 18 subjects with low or intermediate-1 risk who were eligible for ICT due to elevated ferritin levels (13 patients), clinical and biochemical evidence of iron overload (3 patients), and number of transfusions received (2 patients). These subjects were treated with a chelating agent, desferroxamine (0.5-3 g), through subcutaneous infusion over 12 hours, 5 days per week. The median duration of treatment was 15 months.

When compared with non-ICT patients, patients who received ICT had higher initial median ferritin levels (4,215 vs 1,647 mcg/L) and significantly lower median post-ICT ferritin levels (2,659 mcg/L vs 3,188 mcg/L),

In non-ICT patients who died during the study period (n=71), documented causes of death were acute leukemia (22 patients), MDS-related (21 patients), infection/sepsis (18 patients), and non-MDS-related (10 patients). The 3 deaths among ICT patients were due to AML, MDS complications, and iron overload.

Median overall survival for all subjects was 36 months. Median overall survival was more than 160 months in patients with low or intermediate-1 IPSS receiving ICT and 40.1 months in non-ICT patients.

Four-year survival among patients who received ICT was 80% and 44% among non-ICT patients, the authors noted.

[Presentation title: Improved Survival in Patients with Myelodysplastic Syndrome (MDS) Receiving Iron Chelation Therapy. Abstract 249]