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Clinical view versus guideline adherence in ferritin monitoring and initiating iron chelation therapy in patients with myelodysplastic syndromes.

Authors :
Rozema, Johanne
van Asten, Ivar
Kwant, Beau
Kibbelaar, Robby E.
Veeger, Nic J. G. M.
de Wit, Harry
van Roon, Eric N.
Hoogendoorn, Mels
Source :
European Journal of Haematology; Dec2022, Vol. 109 Issue 6, p772-778, 7p
Publication Year :
2022

Abstract

Objectives: In patients with myelodysplastic syndromes (MDS) with >20 transfusions and ferritin levels >1000 μg/L, international guidelines recommend iron chelation therapy (ICT). The study's objective was to determine guideline adherence and the intensity of ferritin monitoring in clinical practice. Methods: We performed an observational population‐based study using the HemoBase Registry, which contains data of all MDS patients diagnosed since 2005 in Friesland, the Netherlands. Clinical information on transfusions, ferritin measurements, ICT, and clinical performance as defined by age ≤ 80 years, Charlson Comorbidity Index <2 and lower‐risk MDS was collected from health records. Results: Two hundred and thirty seven of 292 patients (81.1%) received ≥1 transfusion, and 121 (41.4%) received >20 transfusions. In 57 of these 121 patients (47.1%), ferritin measurements were performed at least once. Clinical performance was significantly associated with monitoring ferritin around the 20th transfusion (RR: 2.49, p =.016). Clinical performance was also associated with initiating ICT (RR: 5.99, p <.001). ICT was offered to 22.3% (n = 25) of eligible patients. Conclusions: In this population‐based study, ferritin levels were measured in <50% of MDS patients who received >20 transfusions, and clinical performance was significantly associated with measuring ferritin. Our study suggests that in heavily transfused MDS patients, ferritin monitoring is primarily based on patients' clinical performance rather than guideline recommendations. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09024441
Volume :
109
Issue :
6
Database :
Complementary Index
Journal :
European Journal of Haematology
Publication Type :
Academic Journal
Accession number :
160177048
Full Text :
https://doi.org/10.1111/ejh.13865