Treatment patterns and outcomes in patients with myelodysplastic syndromes treated with hypomethylating agents: a SEER-Medicare analysis

Leuk Lymphoma. 2021 Jun;62(6):1411-1421. doi: 10.1080/10428194.2020.1869959. Epub 2021 Jan 11.

Abstract

To describe real-world treatment patterns and outcomes among adult patients with myelodysplastic syndromes (MDS) treated with hypomethylating agents (HMA), patients were identified in the SEER-Medicare database (01/2006-12/2016); 3,046 patients with MDS treated with HMA were included. An algorithm was developed to categorize patients into MDS risk groups: the majority of patients were classified as Higher-risk (70.9%), 8.0% as Intermediate-risk, and 21.1% as Unknown-risk. Overall, 77.4% of patients initiated azacitidine and 22.6% decitabine; they received an average of 5.1 index-HMA cycles, of which 90.9% were complete with a median cycle duration of 28 days. Median survival was 11.6, 18.4, and 19.1 months for the Higher-risk, Intermediate-risk, and Unknown-risk groups, respectively. Median time-to-AML transformation was 19.3 months for the Higher-risk group and 50.4 months for the Intermediate-risk group (not reached for Unknown-risk). Data highlight the unmet medical needs of patients with MDS treated with HMA, particularly for the Higher-risk MDS group.

Keywords: Myelodysplastic syndromes; acute myeloid leukemia transformation; claims database; hypomethylating agents; overall survival; treatment patterns.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antimetabolites, Antineoplastic* / therapeutic use
  • Azacitidine / therapeutic use
  • Decitabine / therapeutic use
  • Humans
  • Medicare
  • Myelodysplastic Syndromes* / drug therapy
  • Treatment Outcome
  • United States / epidemiology

Substances

  • Antimetabolites, Antineoplastic
  • Decitabine
  • Azacitidine