Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data

Hacibekiroglu, Tuba; ASLANER AK, Müzeyyen; Açar, İbrahim halil; bolaman, ali zahit; gedük, ayfer; Polat, Merve Gökçen; Sunu, Cenk; Guvenc, Birol; ERTOP, SEHMUS

doi:10.4274/tjh.galenos.2023.2022.0437

Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data

Müzeyyen ASLANER, (Zonguldak Bülent Ecevit Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Zonguldak, Türkiye)

Ayfer GEDUK, (Kocaeli Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Kocaeli, Türkiye)

İbrahim halil Açar, (Çukurova Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Adana, Türkiye)

Merve Gökçen POLAT, (Kocaeli Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Kocaeli, Türkiye)

Cenk SUNU, (Sakarya Eğitim ve Araştırma Hastanesi, Hematoloji Kliniği, Sakarya, Türkiye)

Zahit BOLAMAN, (Adnan Menderes Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Aydın, Türkiye)

Tuba HACIBEKİROĞLU, (Sakarya Eğitim ve Araştırma Hastanesi, Hematoloji Kliniği, Sakarya, Türkiye)

Birol GÜVENÇ, (Çukurova Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Adana, Türkiye)

Şehmus ERTOP (Zonguldak Bülent Ecevit Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Zonguldak, Türkiye)

Turkish Journal of Hematology

1 1

Yıl: 2023 Cilt: 40 Sayı: 2 Sayfa Aralığı: 92 - 100 Metin Dili: İngilizce DOI: 10.4274/tjh.galenos.2023.2022.0437 İndeks Tarihi: 01-06-2023

Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data

Öz:

Objective: This study was undertaken to evaluate the long-term clinical efficacy of epoetin alfa and darbepoetin alfa in patients with myelodysplastic syndrome (MDS) in a real-life setting. Materials and Methods: A total of 204 patients with low-risk or intermediate-1-risk MDS who received epoetin alfa or darbepoetin alfa were included. Hemoglobin levels and transfusion needs were recorded before treatment and at 12 months, 24 months, 36 months, and 48 months of treatment. Results: At the 36-month (p=0.025) and 48-month (p=0.022) visits, epoetin alfa yielded significantly higher hemoglobin levels compared to darbepoetin alfa. Transfusion needs were also significantly lower with epoetin alfa compared to darbepoetin alfa at 24 months (p=0.012) and in the low-risk group compared to the intermediate-risk group at 24 months (p=0.018), 36 months (p=0.025), and 48 months (p<0.001). Treatment response rates at the 24-month, 36-month, and 48-month visits in the epoetin alfa (43.0%, 33.6%, and 27.1%), darbepoetin alfa (29.9%, 22.7%, and 16.5%), low-risk (39.3%, 30.0%, and 26.0%), and intermediate-risk (29.6%, 24.1%, and 11.1%) groups were lower than those obtained at 12 months, and the values differed significantly for the 36-month and 48-month visits with values ranging from p<0.05 to p<0.001. Conclusion: This real-life long-term ESA extension study investigated the clinical efficacy of epoetin alfa and darbepoetin alfa for up to 48 months, revealing that treatment efficacy reached a plateau starting from the 24th month of therapy with a continuing decrease in treatment response rates regardless of treatment type, risk status, or gender. Nonetheless, significantly higher hemoglobin levels and marked improvement in transfusion needs were evident in epoetintreated patients compared to darbepoetin-treated patients and in the low-risk group compared to the intermediate-risk group.

Anahtar Kelime:

Eritropoezi Stimüle Edici Ajanların Düşük Riskli veya Orta-1 Riskli Myelodisplastik Sendromlu Hastalarda Uzun Dönem Tedavi Etkinliğinin Değerlendirilmesi: Çok Merkezli Gerçek Yaşam Verisi

Öz:

Amaç: Myelodisplastik sendromlu (MDS) hastalarda epoetin alfa ve darbepoetin alfa tedavisinin gerçek yaşam ortamında uzun-dönem klinik etkinliğini değerlendirmek. Gereç ve Yöntemler: Bu çalışmaya düşük veya orta-1 risk grubu MDS tanısı ile epoetin alfa veya darbepoetin alfa tedavisi almış 204 hasta dahil edildi. Hemoglobin düzeyleri ve transfüzyon gereksinimi, tedaviden önce ve tedavinin 12., 24., 36. ve 48. aylarında değerlendirildi. Bulgular: Epoetin alfa, darbepoetin alfa ile kıyaslandığında, 36. ay (p=0,025) ve 48. aylarda (p=0,022) anlamlı şekilde daha yüksek hemoglobin düzeylerini sağladı. Transfüzyon gereksinimi 24. ayda (p=0,012) epoetin alfa grubunda darbepoetin alfa grubuna göre, 24. ay (p=0,018), 36. ay (p=0,025) ve 48. aylarda (p<0,001) ise düşük risk grubunda orta risk grubuna göre anlamlı şekilde daha düşük olarak bulundu. Tedavi yanıt oranları 24. ay, 36. ay ve 48. aylarda epoetin alfa (%43,0, %33,6 ve %27,1), darbepoetin alfa (%29,9, %22,7 ve %16,5), düşük risk (%39,3, %30,0 ve %26,0) ve orta risk (%29,6, %24,1 ve %11,1) gruplarında 12. ay yanıt oranlarına göre daha düşük olup, 36. ve 48. aylarda bu değişim istatistiksel olarak anlamlı idi (p<0,05 ile <0,001 arası). Sonuç: Epoetin alfa ve darbepoetin alfanın 48 aylık klinik etkililiğinin değerlendirildiği bu gerçek-yaşam uzun-dönem ESA çalışmasında, tedavi etkililiğinin tedavinin 24. ayından başlayarak plato evresine eriştiği ve devamında tedavi yanıt oranlarında, tedavi tipi, risk durumu veya cinsiyetten bağımsız olarak süregiden bir düşüşün gerçekleştiği saptandı. Bununla birlikte, epoetin tedavisi alan grupta darbepoetin ile tedavi edilen gruba göre ve düşük risk grubu hastalarda orta risk grubu hastalara göre, hemoglobin düzeyleri anlamlı şekilde daha yüksek olup, transfüzyon gereksiniminde de belirgin azalma olduğu tespit edildi.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ASLANER AK M, gedük a, Açar İ, Polat M, Sunu C, bolaman a, Hacibekiroglu T, Guvenc B, ERTOP S (2023). Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. , 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
Chicago	ASLANER AK Müzeyyen,gedük ayfer,Açar İbrahim halil,Polat Merve Gökçen,Sunu Cenk,bolaman ali zahit,Hacibekiroglu Tuba,Guvenc Birol,ERTOP SEHMUS Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. (2023): 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
MLA	ASLANER AK Müzeyyen,gedük ayfer,Açar İbrahim halil,Polat Merve Gökçen,Sunu Cenk,bolaman ali zahit,Hacibekiroglu Tuba,Guvenc Birol,ERTOP SEHMUS Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. , 2023, ss.92 - 100. 10.4274/tjh.galenos.2023.2022.0437
AMA	ASLANER AK M,gedük a,Açar İ,Polat M,Sunu C,bolaman a,Hacibekiroglu T,Guvenc B,ERTOP S Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. . 2023; 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
Vancouver	ASLANER AK M,gedük a,Açar İ,Polat M,Sunu C,bolaman a,Hacibekiroglu T,Guvenc B,ERTOP S Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. . 2023; 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
IEEE	ASLANER AK M,gedük a,Açar İ,Polat M,Sunu C,bolaman a,Hacibekiroglu T,Guvenc B,ERTOP S "Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data." , ss.92 - 100, 2023. 10.4274/tjh.galenos.2023.2022.0437
ISNAD	ASLANER AK, Müzeyyen vd. "Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data". (2023), 92-100. https://doi.org/10.4274/tjh.galenos.2023.2022.0437

APA	ASLANER AK M, gedük a, Açar İ, Polat M, Sunu C, bolaman a, Hacibekiroglu T, Guvenc B, ERTOP S (2023). Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. Turkish Journal of Hematology, 40(2), 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
Chicago	ASLANER AK Müzeyyen,gedük ayfer,Açar İbrahim halil,Polat Merve Gökçen,Sunu Cenk,bolaman ali zahit,Hacibekiroglu Tuba,Guvenc Birol,ERTOP SEHMUS Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. Turkish Journal of Hematology 40, no.2 (2023): 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
MLA	ASLANER AK Müzeyyen,gedük ayfer,Açar İbrahim halil,Polat Merve Gökçen,Sunu Cenk,bolaman ali zahit,Hacibekiroglu Tuba,Guvenc Birol,ERTOP SEHMUS Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. Turkish Journal of Hematology, vol.40, no.2, 2023, ss.92 - 100. 10.4274/tjh.galenos.2023.2022.0437
AMA	ASLANER AK M,gedük a,Açar İ,Polat M,Sunu C,bolaman a,Hacibekiroglu T,Guvenc B,ERTOP S Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. Turkish Journal of Hematology. 2023; 40(2): 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
Vancouver	ASLANER AK M,gedük a,Açar İ,Polat M,Sunu C,bolaman a,Hacibekiroglu T,Guvenc B,ERTOP S Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data. Turkish Journal of Hematology. 2023; 40(2): 92 - 100. 10.4274/tjh.galenos.2023.2022.0437
IEEE	ASLANER AK M,gedük a,Açar İ,Polat M,Sunu C,bolaman a,Hacibekiroglu T,Guvenc B,ERTOP S "Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data." Turkish Journal of Hematology, 40, ss.92 - 100, 2023. 10.4274/tjh.galenos.2023.2022.0437
ISNAD	ASLANER AK, Müzeyyen vd. "Long-Term Efficacy of Erythropoiesis-Stimulating Agents in Patients with Low-Risk or Intermediate-1-Risk Myelodysplastic Syndrome: Multicenter Real-Life Data". Turkish Journal of Hematology 40/2 (2023), 92-100. https://doi.org/10.4274/tjh.galenos.2023.2022.0437