Pb2032: factors associated with transfusion independency post treatment in high risk mds patients

Topic: 10. Myelodysplastic syndromes - Clinical Background: One of the potential advances in the treatment of high risk myelodysplastic syndromes (MDS) has been the use of hypomethylating agents (HMA) in combination with the Bcl-2 inhibitor venetoclax (VEN). This therapy has been found to be expedient in patients who never achieve hematological recovery and experience morbidity and quality of life problems as a result of repeated transfusions, infections, and hospitalizations. Aims: The study was conducted to observe the factors associated with transfusion independence post treatment with HMA-VEN therapy in high risk MDS patients. Methods: We analyzed 19 high risk MDS patients who received treatment with HMA i.e. decitabine or azacitidine, along with VEN. Chi square and Mann Whitney U test were performed and p-value <0.05 was considered significant. Results: Median age of patients was 50(23-69) years with male predominance 14 (74%). Median total leucocyte count (TLC), hemoglobin (Hb), platelet count (PC) and blast cells (BC) at baseline was 9.6 x10^9/L, 8.8g/dL, 27 x10^9/ and 42% respectively. However; after median 3 (1-12) HMA-VEN cycles, they were 3.41 x10^9/L, 9.6g/dL, 31 x10^9/L and 1% respectively. Transfusion dependency was observed in 16(84%) patients pre-treatment and it was resolved in 8(42%) patients post-treatment. Overall, complete response (CR) was achieved in 7(37%) patients. The transfusion independency post treatment was observed with age, gender, cytogenetics, response, TLC, Hb, PC, BC and number of cycles and it was observed that patient who achieved the response and who received 5 (1-12) HMA-VEN cycles became transfusion independent (p=<0.05). Summary/Conclusion: In conclusion, our study revealed that treatment response and number of cycles were significantly associated with the post treatment transfusion independency. Transfusion is associated with complications and it is important to address the factors that may have an impact on transfusion independence and improve the quality of life of patients. Further longitudinal studies with larger sample size are needed in this regard. Keywords: Treatment, MDS, Transfusion