Better OS Observed in Patients with Hypoplastic MDS Versus Hypercellular MDS

HOUSTON — The overall survival (OS) for patients with hypoplastic marrow myelodysplastic syndromes (h-MDS) was better when compared to patients with hypercellular MDS (n-MDS), according to a retrospective analysis presented at the 10th Annual Meeting of the Society of Hematologic Oncology (SOHO).

The study, led by Amin Azem, MD, of the Moffitt Cancer Center, sought to understand the characteristics and molecular profile of h-MDS in comparison with n-MDS.

A total of 4,037 patients were identified through the Moffitt Cancer Center MDS registry and split into an h-MDS arm (cellularity less than 30%) and n-MDS arm (cellularity greater than 30%). Of this patient population, 403 (10%) were identified by the investigators as having a diagnosis of h-MDS. Patients with MDS/myeloproliferative neoplasms were excluded from the analysis.

The median age at diagnosis was 65 years for h-MDS and 68 years for n-MDS (P=.03), and patients with h-MDS were more likely to be female (41% vs 35%; P=.008).

The results showed that the median OS for patients with h-MDS was 41.6 months compared to 35 months in patients with n-MDS (P=.05).

“The OS for h-MDS is better than n-MDS, which tended to have more frequency of splicing and epigenetic somatic mutations,” the investigators reported.

Patients with h-MDS had more thrombocytopenia, neutropenia, and were more likely to be platelet transfusion dependent. Only 22% of h-MDS patients responded to lenalidomide, whereas in the n-MDS arm, the response was 46% (P=.001). However, among patients with h-MDS, there was a better response to antithymocyte globulin/cyclosporine compared to patients with n-MDS (46% vs 21%; P=.019).

Dr. Azem and colleagues noted that somatic mutations were detected more frequently in n-MDS compared to h-MDS, including SF3B1 (P<.005), SRSF2 (P<.005), TET2 (P=.004), and ASXL1 (P=.02).

Dr. Azem and colleagues were honored with an award for their analysis during the poster award ceremony at the 2022 SOHO Annual Meeting.

Reference

Azem A, Ali N, Schwabkey Z, et al. Mutation profiling and characteristics of hypoplastic MDS. Abstract #MDS-504. Presented at the 10th Annual Meeting of the Society of Hematologic Oncology, September 28-October 1, 2022.